| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | CALIFORNIA PHYSICIANS' SERVICE | $27K | $0 | $27K | 5.51% |
| AMWINS3 Filed as: LISI, INC. | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS' SERVICE | $9K | $0 | $9K | 1.75% |
| UNITED SECURITY BANK3 | 1600 W HILL9 RIVER PARK PL EAST SUITE 420 FRESNO, CA 93720 | CALIFORNIA PHYSICIANS' SERVICE | $4K | $0 | $4K | 0.71% |
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | $0 | $1K | 4.75% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OAKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $584 | $0 | $584 | 2.05% |
| HEALTHY SOLUTIONS INSURANCE SERVICE3 Filed as: HEALTHY SOLUTUIONS INSURANCE SERVIC | 55 INDEPENDENCE CIR #108 CHICO, CA 95973 | AMERICAN FIDELITY ASSURANCE COMPANY | $73 | $0 | $73 | 0.26% |
| HEALTHY SOLUTIONS INSURANCE SERVICE3 | 55 INDEPENDENCE CIR #108 CHICO, CA 95973 | AMERICAN FIDELITY ASSURANCE COMPANY | $440 | $0 | $440 | 2.46% |
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $183 | $0 | $183 | 1.02% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OAKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $18 | $0 | $18 | 0.10% |
| HEALTHY SOLUTIONS INSURANCE SERVICE3 | 55 INDEPENDENCE CIR #108 CHICO, CA 95973 | AMERICAN FIDELITY ASSURANCE COMPANY | $204 | $0 | $204 | 2.68% |
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $71 | $0 | $71 | 0.93% |
| GOTTLIEB INSURANCE SERVICES3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | PREMIER ACCESS INSURANCE COMPANY | $964 | $0 | $964 | 20.08% |
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $161 | $0 | $161 | 4.83% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $70 | $0 | $70 | 2.10% |
| HEALTH SOLUTIONS INSURANCE AGENCY3 Filed as: HEALTH SOLUTIONS INSURANCE SERVICES | 55 INDEPENDENCE CIR #108 CHICO, CA 96973 | AMERICAN FIDELITY ASSURANCE COMPANY | $6 | $0 | $6 | 0.18% |
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $314 | $0 | $314 | 15.00% |
| PAUL E GOTTLIEB3 | 9 RIVER PARK PLACE EAST SUITE 420 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $2 | $0 | $2 | 6.67% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 68 | $494K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 95 | $5K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 8 | $2K |
| Short-term disability(2 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 42 | $21K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 1 | $28K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 13 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 95 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.