| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91108 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $37K | $2K | $40K | 3.06% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INSURANCE | 600 B STREET, SUITE 300 SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $18K | $0 | $18K | 1.39% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INSURANCE | 600 B STREET, SUITE 300 SAN DIEGO, CA 92101 | SIMNSA | $19K | $0 | $19K | 5.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 100 PINE STREET, 11TH FLOOR SAN FRANCISCO, CA 94111 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 3.83% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INSURANCE | 600 B STREET, SUITE 300 SAN DIEGO, CA 92101 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 2.15% |
| T2B SOLUTIONS INC.3 Filed as: T2B SOLUTIONS, LLC | 1214 NORTH B STREET INDIANOLA, IA 50125 | STANDARD INSURANCE COMPANY | $0 | $508 | $508 | 0.70% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD SUITE 400 WALNUT CREEK, CA 94596 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.75% |
| BENEFIT PRO INSURANCE SERVICES, INC3 Filed as: BENEFIT PRO INSURANCE SERVICES | 2655 CAMINO DEL RIO NORTH SUITE 370 SAN DIEGO, CA 92108 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 8.75% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INSURANCE | 2777 SOUTH COLORADO BOULEVARD DENVER, CO 80222 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | $0 | $29 | 0.09% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP. SYSTEMS | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $1 | $1 | 0.00% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INSURANCE | 600 B STREET, SUITE 300 SAN DIEGO, CA 92101 | CALIFORNIA DENTAL NETWORK, INC. | $625 | $0 | $625 | 10.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | HARTFORD LIFE AND ACCIDENT | $113 | $30 | $143 | 19.07% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 137 | $1.7M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 137 | $1.7M |
| Vision | STANDARD INSURANCE COMPANY | 314 | $73K |
| Life insurance | STANDARD INSURANCE COMPANY | 314 | $73K |
| Long-term disability | STANDARD INSURANCE COMPANY | 314 | $73K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 137 | $1.7M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 314 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.