| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | CALIFORNIA PHYSICIANS SERVICE | $25K | $205K | $230K | 5.77% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 5.25% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 4.93% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 6.32% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.84% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $12K | — | $12K | 12.35% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $12K | — | $12K | 12.57% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 5.22% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.97% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKALAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 7.07% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.94% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $8K | — | $8K | 14.73% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O.BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.80% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 5.33% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.84% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARNTERS INSURANCE CENTER | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 13.72% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $21K | — | $21K | 68.20% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 6.66% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $10K | — | $10K | 63.25% |
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 | 634 | 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) | 634 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(13 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 634 | $4.7M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 634 | $4.0M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 634 | $4.0M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 1,084 | $33K |
| Short-term disability(12 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 70 | $760K |
| Long-term disability(12 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 70 | $760K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 634 | $4.0M |
| Other(13 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 1,084 | $793K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,084 | — |
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.