| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | CALIFORNIA PHYSICIANS SERVICE (BLUE SHIELD OF CALIFORNIA) | $175K | $98 | $175K | 5.92% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 4.58% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | UNION SECURITY INSURANCE COMPANY | $5K | $7K | $12K | 5.21% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | UDC DENTAL OF CALIFORNIA, INC. | $1K | $356 | $2K | 12.94% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | UNION SECURITY DENTALCARE OF GEORGIA, INC. | — | $80 | $80 | 3.04% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | UNITED DENTAL CARE OF TEXAS, INC. | — | $74 | $74 | 2.92% |
| CENTENNIAL GROUP BENEFITS3 | 245 FISCHER AVENUE, SUITE A2 COSTA MESA, CA 92626 | UNITED DENTAL CARE OF COLORADO, INC. | $80 | $21 | $101 | 12.64% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE (BLUE SHIELD OF CALIFORNIA) | 230 | $3.2M |
| Dental(5 contracts, 5 carriers) | UNION SECURITY INSURANCE COMPANY | 185 | $244K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $26K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $56K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE (BLUE SHIELD OF CALIFORNIA) | 230 | $3.2M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.