| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC JACOBSON3 Filed as: MARC J JACOBSON | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | BLUE CROSS OF CALIFORNIA | $50K | — | $50K | 2.47% |
| KYLAS INSURANCE & FINANCIAL SERVICE3 | 21515 HAWTHORNE BOULEVARD SUITE 1059 TORRANCE, CA 90503 | BLUE CROSS OF CALIFORNIA | $40K | — | $40K | 1.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 0.65% |
| MARC JACOBSON3 | 5 REVERE DRIVE #400 NORTHBROOK, IL 60062 | BLUE CROSS OF CALIFORNIA | $10K | — | $10K | 0.49% |
| MARC JACOBSON3 | 425 HUEHL ROAD BUILDING 16B NORTHBROOK, FL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $865 | $5K | 11.59% |
| KYLAS INSURANCE & FINANCIAL SERVICE3 | 21515 HAWTHORNE BOULEVARD SUITE 1059 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 6.66% |
| MARC JACOBSON3 | 425 HUEHL ROAD BUILDING 16B NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $471 | $4K | 14.04% |
| KYLAS INSURANCE & FINANCIAL SERVICE3 | 21515 HAWTHORNE BOULEVARD SUITE 1059 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 7.70% |
| MARC JACOBSON3 | 425 HUEHL ROAD BUILDING 16B NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $296 | $2K | 15.53% |
| KYLAS INSURANCE & FINANCIAL SERVICE3 | 21515 HAWTHORNE BOULEVARD SUITE 1059 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 8.62% |
| MARC JACOBSON3 Filed as: MARC J JACOBSON | 425 HUEHL ROAD BUILDING 16B NORTHBROOK, IL 60062 | HYATT LEGAL PLANS | $1K | $426 | $1K | 14.16% |
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 | 307 | 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) | 307 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 228 | $2.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 228 | $2.0M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 315 | $48K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 315 | $48K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 24 | $18K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 240 | $44K |
| Other(5 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 315 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.