| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 13500 EVENING CREEK DRIVE SUITE 450 SAN DIEGO, CA 92128 | CALIFORNIA PHYSICIANS SERVICE | $0 | $57K | $57K | 4.36% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS SERVICE | $0 | $12K | $12K | 0.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | EMBLEM HEALTH | $14K | $0 | $14K | 3.10% |
| LOCKTON COMPANIES, LLC3 | 635 BROADWAY, SUITE 100 SONOMA, CA 95476 | EMBLEM HEALTH | $3K | $0 | $3K | 0.75% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | HARTFORD LIFE AND ACCIDENT | $13K | $12K | $24K | 13.10% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS | 9370 SKY PARK COURT SAN DIEGO, CA 92123 | HARTFORD LIFE AND ACCIDENT | $15K | $0 | $15K | 7.90% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $10K | $0 | $10K | 5.34% |
| LOCKTON COMPANIES, LLC3 | 635 BROADWAY, SUITE 100 SONOMA, CA 95476 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 4.38% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS-ALLEN & HALL, INC. | 115 OFFICE PARK DRIVE, SUITE 200 MOUNTAIN BROOK, AL 35223 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $126 | $126 | 2.45% |
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 | 554 | 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) | 554 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 157 | $1.8M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 110 | $5K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 110 | $5K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 600 | $186K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 600 | $186K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 600 | $186K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 157 | $1.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 600 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 600 | — |
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.