| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMS AND ASSOCIATES INS. BROKERS3 Filed as: POMS & ASSOCIATES INS. BROKERS | 5700 CANOGA AVENUE, SUITE 400 WOODLAND HILLS, CA 91357 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $0 | $14K | 13.00% |
| TOLMAN AND WIKER INS. SVCS., LLC3 Filed as: TOLMAN & WIKER INSURANCE SVCS, LLC | 196 SOUTH FIR STREET VENTURA, CA 93001 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 6.55% |
| POMS AND ASSOCIATES INS. BROKERS3 Filed as: POMS & ASSOCIATES INS. BROKERS | 4500 PARK GRANADA, SUITE 206 CALABASAS, CA 91302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | — | $9K | 9.93% |
| ASSUREDPARTNERS3 | PO BOX 1388 VENTURA, CA 93002 | UNUM INSURANCE COMPANY | $957 | $57 | $1K | 10.12% |
| UNKNOWN3 | UNKNOWN SALT LAKE CITY, UT 84101 | BLOMQUIST HALE | $42 | — | $42 | 4.98% |
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 | 65 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 66 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 62 | $92K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 62 | $92K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 65 | $109K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 65 | $109K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 65 | $109K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 217 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.