| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS PRO INS. SERVICES, INC.3 | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | BLUE CROSS OF CALIFORNIA | $46K | $0 | $46K | 3.44% |
| VIRTUS LLC3 Filed as: VIRTUS, LLC | 4550 WEST 109TH STREET, SUITE 301 LEAWOOD, KS 66211 | BLUE CROSS OF CALIFORNIA | $11K | $0 | $11K | 0.82% |
| BENEFITS PRO INS. SERVICES, INC.3 | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $4K | $13K | 18.30% |
| VIRTUS LLC3 Filed as: VIRTUS, LLC | 4550 WEST 109TH STREET, SUITE 301 LEAWOOD, KS 66211 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.63% |
| BENEFITS PRO INS. SERVICES, INC.3 | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.05% |
| VIRTUS LLC3 Filed as: VIRTUS, LLC | 4550 WEST 109TH STREET, SUITE 303 LEAWOOD, KS 66211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.95% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $363 | $363 | 1.03% |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 255 | $1.3M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 255 | $1.4M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 255 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $107K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $35K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.