| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $75K | $10K | $85K | 18.58% |
| FREDERICK W. HOWARTH III3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70K | — | $70K | 19.08% |
| FREDERICK W. HOWARTH III3 Filed as: FREDERICK HOWARTH III | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $54K | — | $54K | 15.00% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE,USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $207 | $207 | 0.06% |
| FREDERICK W. HOWARTH III3 | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY | $6K | $959 | $7K | 16.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMIN | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $12K |
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 | 541 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 549 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 1,182 | $15.9M |
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 1,182 | $15.9M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 555 | $37K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,191 | $358K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $460K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 1,182 | $15.9M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,191 | $766K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,191 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.