| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $55K | — | $55K | 10.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $41K | — | $41K | 7.55% |
| EVEREST FUNERAL PACKAGE LLC5 | 1300 POST OAK BLVD SUITE 1210 HOUSTON, TX 77056 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $433 | $433 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 ADMIN SVCS | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $245K |
| ALLSUP INC. VENDOR SVCS | Insurance services Service code 23 | 300 ALLSUP PLACE BELLEVILLE, IL 622238626 | $23K |
| MEDICAL EVALUATION SPECIALISTS, INC DISABILITY VENDOR SVCS | Insurance services Service code 23 | PO BOX 3208 WOBUM, MA 01888 | $13K |
| RELIABLE RS DISABILITY VENDOR SVCS | Insurance services Service code 23 | PO BOX 492890 REDDING, CA 96049 | $10K |
| ETHOS RISK SERVICE DISABILITY VENDOR SVCS | Insurance services Service code 23 | PO BOX 55246 ST. PETERSBURG, FL 33732 | $6K |
| MLS GROUP OF COMPANIES, INC. DISABILITY VENDOR SVCS | Insurance services Service code 23 | 29000 INKSTER ROAD SOUTHFIELD, MI 48034 | $5K |
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 | 6,387 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 230 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,617 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 9,067 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,067 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.