| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DH INSURANCE SERVICES3 Filed as: DH INSURANCE SERVICES, INC. | 2727 WALSH AVENUE, SUITE 220 SANTA CLARA, CA 95051 | ANTHEM BLUE CROSS | $34K | $0 | $34K | 2.14% |
| DH INSURANCE SERVICES3 Filed as: DH INSURANCE SERVICES, INC. | 2727 WALSH AVENUE, SUITE 220 SANTA CLARA, CA 95051 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 3.30% |
| ENROLLEASE3 | 660 YORK STREET, SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $946 | $0 | $946 | 0.85% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS, LLC | 333 INDIAN HILLS BOULEVARD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5 | $0 | $5 | 0.00% |
| DH INSURANCE SERVICES3 Filed as: DH INSURANCE SERVICES, INC. | 2727 WALSH AVENUE, SUITE 220 SANTA CLARA, CA 95051 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 4.97% |
| DH INSURANCE SERVICES3 Filed as: DH INSURANCE SERVICES, INC. | 2727 WALSH AVENUE, SUITE 220 SANTA CLARA, NV 95051 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.98% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC. | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $481 | $0 | $481 | 1.06% |
| DH INSURANCE SERVICES3 Filed as: DH INSURANCE SERVICES, INC. | 2727 WALSH AVENUE, SUITE 220 SANTA CLARA, CA 95051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 11.53% |
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 | 60 | 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) | 60 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 100 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 59 | $111K |
| Vision | VISION SERVICE PLAN | 80 | $45K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 60 | $36K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 60 | $36K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 60 | $36K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 8 | $66K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 60 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.