| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JTW & ASSOCIATES INC3 | 940 S COAST DR STE 190 COSTA MESA, CA 92626 | ANTHEM BLUE CROSS AND HEALTH INSURANCE CO. | $28K | — | $28K | 4.96% |
| JTW & ASSOCIATES INC3 | 940 S COAST DR STE 190 COSTA MESA, CA 926267798 | KAISER FOUNDATION HEALTH PLAN INC | $23K | — | $23K | 4.85% |
| JTW & ASSOCIATES INC3 | 940 S COAST DR STE 190 COSTA MESA, CA 926267798 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 5.00% |
| JTW & ASSOCIATES INC3 | 940 S COAST DR STE 190 COSTA MESA, CA 92626 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 5.22% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVER STE 250 IRVINE, CA 92618 | UNITED HEALTHCARE INSURANCE COMPANY | -$1 | — | -$1 | -0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CALIFORNIA INS SVCS | 38 DISCOVERY STE 250 IRVINE, CA 92618 | UNITED HEALTHCARE INSURANCE COMPANY | -$6 | — | -$6 | -0.01% |
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 | 254 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | ANTHEM BLUE CROSS AND HEALTH INSURANCE CO. | 136 | $1.2M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 254 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.