| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER, SUITE A-2 COSTA MESA, CA 92626 | BLUE CROSS OF CALIFORNIA | $31K | — | $31K | 5.15% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER, SUITE A-2 COSTA MESA, CA 92626 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | — | $11K | 4.60% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER, SUITE A-2 COSTA MESA, CA 92626 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 4.58% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER, SUITE A-2 COSTA MESA, CA 92626 | UNION SECURITY INSURANCE COMPANY | $4K | $1K | $5K | 12.93% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER, SUITE A-2 COSTA MESA, CA 92626 | UDC DENTAL OF CALIFORNIA, INC. | $2K | $619 | $3K | 13.11% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER, SUITE A-2 COSTA MESA, CA 92626 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $733 | — | $733 | 5.15% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 70 | $1.0M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 125 | $62K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 113 | $14K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 125 | $42K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 70 | $1.0M |
| Other | UNION SECURITY INSURANCE COMPANY | 125 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.