| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRADAWN INSURANCE SERVICES, INC.3 | 800 W. VALLEY PARKWAY SUITE 114 ESCONDIDO, CA 92025 | UNIMERICA | $17K | $0 | $17K | 7.50% |
| BRADAWN INSURANCE SERVICES, INC.3 | 800 W. VALLEY PARKWAY SUITE 114 ESCONDIDO, CA 92025 | UNIMERICA | $8K | $0 | $8K | 7.50% |
| BRADAWN INSURANCE SERVICES, INC.3 | 800 W. VALLEY PARKWAY SUITE 114 ESCONDIDO, CA 92025 | MEDICAL EYE SERVICES | $1K | $0 | $1K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 621 SANTA FE AVENUE FRESNO, CA 93721 | $92K |
| ANTHEM BLUE CROSS EIN 95-3760980 OTHER FEES | Other fees Service code 99 | 21555 OXNARD STREET WOODLAND HILLS, CA 91367 | $20K |
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 | 153 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | MEDICAL EYE SERVICES | 151 | $22K |
| Life insurance | UNIMERICA | 153 | $108K |
| Long-term disability | UNIMERICA | 153 | $224K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE | 151 | $225K |
| Other | UNIMERICA | 153 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.