| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | BLUE CROSS OF CALIFORNIA | $54K | $1K | $55K | 6.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | SUTTER HEALTH PLAN | $25K | — | $25K | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.59% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $745 | $19 | $764 | 6.01% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 20.14% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $216 | $216 | 1.95% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $324 | $324 | 3.12% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $74 | — | $74 | 9.99% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION INC. | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $50 | $50 | 6.75% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $100 | — | $100 | 15.02% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION INC. | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $20 | $20 | 3.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $54 | — | $54 | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $77 | — | $77 | 14.95% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION INC. | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12 | $12 | 2.33% |
| PLANSOURCE BEN ADMINISTRATION INC5 Filed as: PLANSOURCE BEN ADMINISTRATION INC. | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $84 | $84 | 17.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $70 | — | $70 | 14.99% |
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 | 471 | 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) | 472 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 189 | $1.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 189 | $923K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 155 | $13K |
| Life insurance(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 471 | $39K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 41 | $13K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 189 | $1.4M |
| Other(8 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 471 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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.