| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 | 220 BUSH STREET 7TH FLOOR SAN FRANCISCO, CA 94104 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.65% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 3155 OLSEN DRIVE, SUITE 400 SAN JOSE, CA 95117 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.44% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP, WEST, LLC | 2211 MICHELSON DR. STE 1200 IRVINE, CA 92612 | TRANSAMERICA LIFE INSURANCE COMPANY | $610 | — | $610 | 1.73% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $818 | $818 | 2.55% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | — | $2K | 9.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIRECT DENTAL ADMINISTRATORS,LLC EIN 68-0119127 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 7510 SHORELINE DRIVE STOCKTON, CA 95219 | $13K |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 136 | $2.0M |
| Vision | VISION SERVICE PLAN | 166 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $32K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $32K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 136 | $2.0M |
| Other(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 161 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.