| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | BLUE SHIELD OF CALIFORNIA | $511K | — | $511K | 4.86% |
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN | $105K | — | $105K | 4.86% |
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | THE STANDARD - DENTAL | $13K | — | $13K | 4.86% |
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | UNITED CONCORDIA DENTAL PLANS OF CA | $13K | — | $13K | 4.86% |
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | AETNA VISION | $2K | — | $2K | 4.86% |
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | AVESIS - STANDARD VISION | $2K | — | $2K | 4.86% |
| WEST COAST GROUP BENEFITS3 | 10809 THORNMINT ROAD, SUITE A SAN DIEGO, CA 92127 | UNITED HEALTH CARE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| POLYCOMP ADMINISTRATIVE SERVICES EIN 95-2889854 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 404 CAMINO DEL RIO SOUTH SUITE 608 SAN DIEGO, CA 92108 | $388K |
| WOLDS LAW GROUP EIN 80-0462356 TRUST ATTORNEY | Legal Service code 29 | 4747 EXECUTIVE DRIVE, STE 250 SAN DIEGO, CA 92121 | $143K |
| ABC OF SOUTHERN CALIFORNIA, INC EIN 95-2893577 PLAN SPONSOR/ADMIN FEES | Plan Administrator Service code 14 | 1400 NORTH KELLOGG DRIVE, STE A ANAHEIM, CA 92807 | $52K |
| JHS CPAS, LLP EIN 81-0865829 TRUST ACCOUNTANTS | Accounting (including auditing) Service code 10 | 135 TOWN COUNTRY DRIVE DANVILLE, CA 94526 | $50K |
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 | 1,783 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 1,419 | $12.7M |
| Dental(2 contracts, 2 carriers) | THE STANDARD - DENTAL | 911 | $541K |
| Vision(2 contracts, 2 carriers) | AETNA VISION | 1,018 | $82K |
| Life insurance | UNITED HEALTH CARE LIFE INSURANCE COMPANY | 1,217 | $26K |
| Other | BLUE SHIELD OF CALIFORNIA | 1,419 | $10.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,419 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.