| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 4170 DOUGLAS BLVD., SUITE 100 GRANITE BAY, CA 95746 | CALIFORNIA PHYSICIANS SERVICE | $164 | $59K | $59K | 5.26% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 4170 DOUGLAS BLVD., SUITE 100 GRANITE BAY, CA 95746 | GUARDIAN | $20K | — | $20K | 10.27% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 4170 DOUGLAS BLVD., SUITE 100 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 4.66% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 4170 DOUGLAS BLVD., SUITE 100 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 5.18% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $128 | $2K | 5.77% |
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 | 176 | 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) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 92 | $1.4M |
| Dental | GUARDIAN | 176 | $191K |
| Vision | GUARDIAN | 176 | $191K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 176 | $232K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 176 | $232K |
| Long-term disability | GUARDIAN | 176 | $191K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 92 | $1.4M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 176 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.