| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 2030 MAIN STREET, SUITE 200 IRVINE, CA 92614 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 4.90% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.32% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $499 | $499 | 1.86% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $424 | — | $424 | 9.49% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $85 | $85 | 1.90% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 175 | $272K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 90 | $31K |
| Vision | BLUE CROSS OF CALIFORNIA | 175 | $272K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 175 | $272K |
| Other | BLUE CROSS OF CALIFORNIA | 175 | $272K |
| 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.
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.