| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERED INSURANCE SOLUTIONS, INC.3 | 1100 FLYNN RD, SUITE 102 CAMARILLO, CA 93012 | BLUE CROSS OF CALIFORNIA | $16K | — | $16K | 3.36% |
| CENTERED INSURANCE SOLUTIONS, INC.3 | 1100 FLYNN RD, SUITE 102 CAMARILLO, CA 93012 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 4.52% |
| CENTERED INSURANCE SOLUTIONS, INC.3 | 1100 FLYNN RD, SUITE 102 CAMARILLO, CA 93012 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $171 | — | $171 | 3.37% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 99 | $476K |
| Dental | BLUE CROSS OF CALIFORNIA | 99 | $476K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 71 | $5K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 150 | $27K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 150 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.