| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | BLUE CROSS BLUE SHIELD OF ARIZONA | $15K | — | $15K | 3.77% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | CALIFORNIA PHYSICIANS SERVICE | $10K | — | $10K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 S PARKER ST, 8TH FL ORANGE, CA 92868 | CALIFORNIA PHYSICIANS SERVICE | — | $5K | $5K | 2.38% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC. | $2K | — | $2K | 2.31% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | UNITED HEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| VARIOUS - SEE ATTACHMENT3 | C/O COLONIAL PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 21.16% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| VARIOUS - SEE ATTACHMENT3 | C/O COLONIAL PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $110 | $1K | 12.47% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $672 | — | $672 | 10.00% |
| VAROIUS - SEE ATTACHMENT3 | C/O COLONIAL PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $297 | $31 | $328 | 11.04% |
| VARIOUS - SEE ATTACHMENT3 | C/O PAUL REVERE PO BOX 1365 COLUMBIA, SC 29202 | THE PAUL REVERE LIFE INSURANCE COMPANY | $76 | — | $76 | 7.92% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 48 | $689K |
| Dental(2 contracts, 2 carriers) | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC. | 175 | $144K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 175 | $60K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $20K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 48 | $689K |
| Other(6 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 121 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.