| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | DELTA DENTAL OF CALIFORNIA | — | — | $0 | 0.00% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | 0.00% |
| CYNTHIA L. MOHON4 Filed as: CYNTHIA L MOHON | 15 N MICHIGAN ST REDLANDS, CA 92373 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $159 | — | $159 | 4.69% |
| DEBRA OTTEN4 Filed as: DEBRA L OTTEN | 1808 KINGS LAKE BLVD., APT 104 NAPLES, FL 34112 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $91 | — | $91 | 2.68% |
| PAM MROZ4 | 6770 BRADFORD CT CHINO, CA 91710 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $33 | — | $33 | 0.97% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | — |
| NONE | — | TRANSAMERICA LIFE INSURANCE COMPANY | — | — | $0 | — |
| NONE | — | DELTA DENTAL OF CALIFORNIA | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OCEA EIN 33-0660405 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $1.1M |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $395K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $160K |
| DIMARTINO ASSOCIATES EIN 91-0378940 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $111K |
| HIGHLAND CAPITAL ADVISORS LLC EIN 20-4284376 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $15K |
| THE WAGNER LAW GROUP EIN 04-3323315 NONE | Legal; Direct payment from the plan Service code 29 | — | $12K |
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 | 11,159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,579 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,738 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 13,618 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 24,637 | $1.6M |
| Short-term disability | STANDARD INSURANCE COMPANY | 12,023 | $825K |
| Long-term disability(2 contracts) | STANDARD INSURANCE COMPANY | 24,637 | $2.0M |
| Other | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 17 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 24,637 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.