| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 5850 GRANITE PARKWAY, SUITE 350 PLANO, TX 75024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $92K | $0 | $92K | 4.09% |
| HAYS COMPANIES, INC.3 | 2 PARK PLAZA, SUITE 440 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $0 | $11K | 15.00% |
| BETTY MURDOCK3 | 7216 TESSERA PARKWAY LAGO VISTA, TX 78645 | AFLAC | $1K | $0 | $1K | 3.29% |
| KATHLEEN S HANSON3 Filed as: KATHLEEN S. HANSON AND OTHER AGENTS | 5460 EAST EL PARQUE STREET LONG BEACH, CA 90815 | AFLAC | $917 | $20 | $937 | 2.73% |
| CLAY W CAMPBELL3 Filed as: CLAY W. CAMPBELL | 14720 LIBLEN AVENUE BELLFLOWER, CA 90706 | AFLAC | $579 | $0 | $579 | 1.69% |
| ANDREA M MACIAS3 Filed as: ANDREA M. MACIAS | 7216 TESSERA PARKWAY LAGO VISTA, TX 78645 | AFLAC | $412 | $0 | $412 | 1.20% |
| JUANITA BURKS & ASSOCIATES3 Filed as: JUANITA BURKS AND ASSOCIATES | PO BOX 10341 MARINA DEL REY, CA 90295 | AFLAC | $274 | $20 | $294 | 0.86% |
| AUDREY S. CORLEY3 | 5827 VISTA DEL CABELLERO RIVERSIDE, CA 92509 | AFLAC | $169 | $0 | $169 | 0.49% |
| VANESSA IRENE HERRERA3 | 200 EAST AVENIDA DE LA MERCED MONTEBELLO, CA 90640 | AFLAC | $72 | $86 | $158 | 0.46% |
| STRATEGIC NON-MEDICAL SOLUTION3 | ONE BEACON STREET, SUITE 17100 BOSTON, MA 02108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 7.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 7.50% |
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 | 341 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 341 | $2.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 341 | $2.3M |
| Vision | VISION SERVICE PLAN | 143 | $17K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 341 | $74K |
| Short-term disability | AFLAC | 28 | $34K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 341 | $74K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 341 | $2.3M |
| Other(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 853 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 853 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.