| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS ALLIANCE INSURANCE SERVICE3 Filed as: BENEFITS ALLIANCE INSURANCE SVCS | — | BLUE CROSS OF CALIFORNIA | $11K | — | $11K | 2.50% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | BLUE CROSS OF CALIFORNIA | $10K | — | $10K | 2.22% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SERVICE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | BLUE CROSS OF CALIFORNIA | — | $8K | $8K | 1.91% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 31248 OAK CREST DR #140 WESTLAKE VILLAGE, CA 913614692 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $493 | $3K | 6.82% |
| TRUE NETWORK ADVISORS3 | 1513 AMBER LANE GUNTERSVILLE, AL 35976 | PRINCIPAL LIFE INSURANCE COMPANY | — | $132 | $132 | 0.28% |
| VOLUNTARY BENEFITS SPECIALISTS LLC3 | 289 FARRIS AVE LAS VEGAS, NV 89183 | TRANSAMERICA LIFE INSURANCE COMPANY | $13K | — | $13K | 36.09% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 Filed as: BENEFITS ALLIANCE INSURANCE SVCS | 31248 OAK CREST DR #140 WESTLAKE VILLAGE, CA 913614692 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $216 | — | $216 | 2.50% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $191 | — | $191 | 2.21% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SERVICE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $164 | $164 | 1.90% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 Filed as: BENEFITS ALLIANCE INSURANCE SVCS | BRIDGEPORT BENEFITS 5210 AGOURA HILLS, CA 913012662 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $625 | — | $625 | 8.07% |
| BENEFITMALL3 Filed as: BENEFITMALL.COM INSURANCE AGENCY | 6200 CANOGA AVENUE SUITE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$248 | $636 | $388 | 5.01% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 Filed as: BENEFITS ALLIANCE INSURANCE SVCS | BRIDGEPORT BENEFITS 5210 LEWIS RD STE 14 AGOURA HILLS, CA 913012662 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $216 | — | $216 | 7.88% |
| BENEFITMALL3 Filed as: BENEFITMALL.COM INSURANCE AGENCY | 6200 CANOGA AVENUE SUITE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $137 | $137 | 5.00% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 Filed as: BENEFITS ALLIANCE INSURANCE SVCS | BRIDGEPORT BENEFITS 5210 AGOURA HILLS, CA 913012662 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $76 | $47 | $123 | 13.17% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 Filed as: BENEFITS ALLIANCE INSURANCE SVCS | BRIDGEPORT BENEFITS 5210 LEWIS RD STE 14 AGOURA HILLS, CA 913012662 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $72 | — | $72 | 7.83% |
| BENEFITMALL3 Filed as: BENEFITMALL.COM INSURANCE AGENCY | 6200 CANOGA AVENUE SUITE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$1 | $47 | $46 | 5.01% |
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 | 98 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 59 | $430K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 68 | $47K |
| Vision(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 68 | $56K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 93 | $8K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 48 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 48 | $934 |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 59 | $430K |
| Other(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 93 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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.