| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 21300 VICTORY BLVD, SUITE 635 WOODLAND HILLS, CA 913672525 | METROPOLITAN LIFE INSURANCE COMPANY | $64K | $24K | $87K | 4.53% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 321 N CLARK ST, SUITE 940 CHICAGO, IL 606545015 | METROPOLITAN LIFE INSURANCE COMPANY | $22K | $8K | $30K | 1.56% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 913672525 | METROPOLITAN LIFE INSURANCE COMPANY | — | $96 | $96 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 913672525 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $5K | $20K | 8.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILS, CA 91367 | AETNA LIFE INSURANCE CO. | — | $2K | $2K | 1.15% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE #635 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE CO. | — | $1K | $1K | 0.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 NONE | Claims processing Service code 12 | — | $185K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $6K |
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 | 4,687 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 93 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,780 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 9 | $67K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 4,750 | $1.4M |
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 4,741 | $475K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 7,720 | $1.9M |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,185 | $33K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,573 | $255K |
| Other(5 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 7,720 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,720 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.