| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS W. FARR3 | 555 PARK CENTER DRIVE, SUITE 118 SANTA ANA, CA 92705 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CA) | — | $102K | $102K | 5.31% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 6200 CANOGA AVENUE, SUITE 300 WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CA) | — | $41K | $41K | 2.11% |
| THOMAS W. FARR3 | 23421 S POINTE DRIVE, SUITE 260 LAGUNA HILLS, CA 926531555 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $21K | — | $21K | 14.10% |
| SUREGUARD INSURANCE AGENCY3 | 23421 S POINTE DRIVE, SUITE 260 LAGUNA HILLS, CA 926531555 | HUMANA INSURANCE COMPANY | $5K | $500 | $6K | 4.30% |
| THOMAS W. FARR3 | 23421 S POINTE DRIVE, SUITE 260 LAGUNA HILLS, CA 926531555 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.05% |
| THOMAS W. FARR3 | 23421 S POINTE DRIVE, SUITE 260 LAGUNA HILLS, CA 926531555 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $1K | — | $1K | 13.83% |
| SUREGUARD INSURANCE AGENCY3 | 555 PARK CENTER DRIVE, SUITE 118 SANTA ANA, CA 92705 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
No Schedule C service providers reported on this filing.
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 | 207 | 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. |
| Total participants (= "Plan participants" tile) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CA) | 185 | $1.9M |
| Dental | HUMANA INSURANCE COMPANY | 185 | $134K |
| Vision | HUMANA INSURANCE COMPANY | 185 | $134K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 84 | $10K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 170 | $148K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CA) | 185 | $1.9M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 207 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.