| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 5.84% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 6.32% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 10.81% |
| AGIS NETWORK INC3 | 2122 KRATKY ROAD ST. LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $944 | $9K | 8.33% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $841 | $9K | 8.23% |
| OLSON, WADE, ROBERT3 Filed as: OLSON, WADE ROBERT | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 7.93% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | SOUTHERN CA SERIES DEPT LA 23940 PASADENA, CA 91185 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 6.84% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD STE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $375 | $375 | 0.60% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $216 | $6K | 10.68% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 7.98% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $499 | $4K | 6.30% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET DBA PRECEPT INSURANCE SOLUTIONS IRVINE, CA 92617 | HYATT LEGAL PLANS | $4K | — | $4K | 10.03% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P O BOX 5668 CONCORD, CA 94524 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $410 | — | $410 | 3.71% |
| LOCKTON COMPANIES, LLC3 | SOUTHERN CA SERIES DEPT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $83 | — | $83 | 0.75% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | SOUTHERN CA SERIES DEPT LA 23940 PASADENA, CA 91185 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $213 | — | $213 | 3.14% |
| OLSON, WADE, ROBERT3 Filed as: OLSON, WADE ROBERT | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.86% |
| LOCKTON COMPANIES, LLC3 | SOUTHERN CA SERIES, DEPT LA 23940 PASADENA, CA 91185 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $103 | — | $103 | 2.17% |
| OLSON, WADE, ROBERT3 | 130 THEORY, SUITE 200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 1.60% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P O BOX 5668 CONCORD, CA 94524 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 1.29% |
| PRECEPT INSURANCE SOLUTIONS3 Filed as: PRECEPT GROUP | 130 THEORY, SUITE 200 IRVINE, CA 92617 | AETNA INTERNATIONAL | $389 | — | $389 | 15.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $783K |
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 | 1,522 | 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) | 1,522 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 67 | $724K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 8 | $134K |
| Vision | VISION SERVICE PLAN | 1,153 | $152K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,540 | $1.2M |
| Short-term disability(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,540 | $1.1M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,540 | $983K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 67 | $724K |
| Other(8 contracts, 6 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,545 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,545 | — |
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.