| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VOLUNTARY BENEFIT ADVISORS3 | 1936 E DEERE AVE., SUITE 125 SANTA ANA, CA 92705 | SYMETRA LIFE INSURANCE COMPANY | $21K | $0 | $21K | — |
| DURRETT, SCOTT F3 | 2 PARK PLAZA, SUITE 1100 IRVINE, CA 92614 | SYMETRA LIFE INSURANCE COMPANY | $11K | $0 | $11K | — |
| SAUCEDO, DANIEL R3 | 235 E BROADWAY, SUITE 520 LONG BEACH, CA 90802 | SYMETRA LIFE INSURANCE COMPANY | $11K | $0 | $11K | — |
| SAUCEDO, DANIEL R3 | 235 E BROADWAY, SUITE 520 LONG BEACH, CA 90802 | SYMETRA LIFE INSURANCE COMPANY | $0 | $7K | $7K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MCDONALD ASSOCIATION MANAGEMENT CO EIN 81-0989479 NA | Copying and duplicating; Contract Administrator; Consulting (general); Account maintenance fees; Plan Administrator; Participant communication; Named fiduciary; Claims processing; Recordkeeping fees; Accounting (including auditing) Service code 10 | 1900 POINT WEST WAY, SUITE 222 SACRAMENTO, CA 95815 | $54K |
| HG CONSULTING GROUP EIN 68-0372388 NA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Participant communication Service code 15 | 3431 FORNEY WAY SACRAMENTO, CA 95816 | $23K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 343 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 343 | $0 |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 343 | $0 |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 343 | $0 |
| Other | SYMETRA LIFE INSURANCE COMPANY | 343 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.