| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | UNITED HEALTHCARE INSURANCE COMPANY | $83K | — | $83K | 4.60% |
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | HEALTH PLAN OF NEVADA | $17K | — | $17K | 3.55% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 8.27% |
| ASSUREX3 Filed as: ASSUREX AGENCY, INC. | 175 SOUTH THIRD STREET, SUITE 800 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $104 | — | $104 | 0.03% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS, INC. | 333 NORTH INDIAN HILL BOULEVARD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $32 | — | $32 | 0.01% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | EYEMED VISION CARE | $4K | — | $4K | 10.44% |
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 | 449 | 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) | 449 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 299 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 449 | $303K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 575 | $337K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 449 | $303K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 449 | $303K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 299 | $2.3M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 449 | $303K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.