| 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% |
| SBHU LIFE AGENCY, INC.4 Filed as: SBHU LIFE AGENCY INC | 700 RED BROOK BLVD. STE. 300 OWING MILLS, MD 21117 | TRANSAMERICA LIFE INSURANCE COMPANY | $15K | — | $15K | 100.00% |
| 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 | 2.65% |
| PAM MROZ4 | 6770 BRADFORD CT CHINO, CA 91710 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $40 | — | $40 | 1.17% |
| 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 | Direct payment from the plan; Claims processing Service code 12 | — | $404K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $158K |
| DIMARTINO ASSOCIATES EIN 91-0378940 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $111K |
| EIDE BAILLY EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $48K |
| HIGHLAND CAPITAL ADVISORS LLC EIN 20-4284376 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $15K |
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 | 10,931 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,613 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 13,887 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 23,124 | $1.7M |
| Short-term disability | STANDARD INSURANCE COMPANY | 12,171 | $847K |
| Long-term disability | STANDARD INSURANCE COMPANY | 13,096 | $2.1M |
| Other | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 16 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 23,124 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.