| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | BLUE CROSS OF CALIFORNIA | $243K | $2K | $245K | 4.80% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $99K | $99K | 1.94% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | — | $30K | 9.55% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET, SUITE 200 ORANGE, CA 928684772 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | — | $13K | 4.16% |
| WWW INSURANCE, LLC3 Filed as: WWW INSURANCE LLC | 430 E. DOUGLAS AVENUE SUITE 400 WICHITA, KS 672023408 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 2.54% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 13.59% |
| WWW INSURANCE, LLC3 Filed as: WWW INSURANCE LLC | 430 E. DOUGLAS AVENUE SUITE 400 WICHITA, KS 672023408 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 8.14% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET, SUITE 200 ORANGE, CA 928684772 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 5.43% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 13.39% |
| WWW INSURANCE, LLC3 Filed as: WWW INSURANCE LLC | 430 E. DOUGLAS AVENUE SUITE 400 WICHITA, KS 672023408 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 8.29% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET, SUITE 200 ORANGE, CA 928684772 | METROPOLITAN LIFE INSURANCE COMPANY | $781 | — | $781 | 5.42% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 13.13% |
| WWW INSURANCE, LLC3 Filed as: WWW INSURANCE LLC | 430 E. DOUGLAS AVENUE SUITE 400 WICHITA, KS 672023408 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 8.60% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET, SUITE 200 ORANGE, CA 928684772 | METROPOLITAN LIFE INSURANCE COMPANY | $709 | — | $709 | 5.44% |
| PATRICIA SWANSON4 | 5153 W. CARAGANA STREET MERIDIAN, ID 836464555 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $1K | — | $1K | 22.02% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON AND COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $361 | — | $361 | 7.15% |
| CHARLES A WALTERS4 Filed as: CHARLES A. WALTERS | 13241 W. GOLDEN PUMA TRAIL PEORIA, AZ 853836067 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $92 | — | $92 | 1.82% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 393 | $5.2M |
| Dental | BLUE CROSS OF CALIFORNIA | 393 | $5.1M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 363 | $318K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 363 | $318K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 363 | $318K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 363 | $318K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 393 | $5.1M |
| Other(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 363 | $380K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 393 | — |
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.