| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIACHOICE | $28K | — | $28K | 4.97% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC. | 225 KENNETH DRIVE ROCHESTER, NY 146234277 | CALIFORNIACHOICE | $156 | — | $156 | 0.03% |
| IMA, INC.3 | 136 E. SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 84111 | BLUE CROSS BLUE SHIELD OF ARIZONA | $4K | — | $4K | 3.68% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC. | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF ARIZONA | $560 | — | $560 | 0.48% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC. | 225 KENNETH DRIVE ROCHESTER, NY 146234277 | CHOICEBUILDER | $4K | — | $4K | 5.68% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CHOICEBUILDER | $3K | — | $3K | 4.32% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE | SERVICES, INC. 32110 AGOURA ROAD, FLOOR 3 WESTLAKE VILLAGE, CA 91361 | CHOICEBUILDER | $3K | — | $3K | 4.28% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | PRINCIPAL LIFE INSURANCE COMPANY | $389 | $552 | $941 | 14.17% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC. | 225 KENNETH DRIVE ROCHESTER, NY 146234277 | PRINCIPAL LIFE INSURANCE COMPANY | $274 | — | $274 | 4.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | AN ALERA GROUP AGENCY LLC 333 N. GLENOAKS BLVD., SUITE 410 BURBANK, CA 915023273 | PRINCIPAL LIFE INSURANCE COMPANY | — | $137 | $137 | 2.06% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | PRINCIPAL LIFE INSURANCE COMPANY | $280 | $118 | $398 | 13.54% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC. | 225 KENNETH DRIVE ROCHESTER, NY 146234277 | PRINCIPAL LIFE INSURANCE COMPANY | — | $342 | $342 | 11.63% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD AND BROWN BENEFIT ADMIN | 721 S. PARKER STREET SUITE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | — | $140 | $140 | 4.76% |
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 | 81 | 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) | 81 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIACHOICE | 56 | $683K |
| Dental | CHOICEBUILDER | 79 | $69K |
| Vision | CHOICEBUILDER | 79 | $69K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 85 | $10K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIACHOICE | 56 | $683K |
| Other(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 85 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 85 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.