| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN RAY GRIFFIN3 Filed as: STEVEN RAY GRIFIN | 2000 MORRIS AVNEUE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 3.19% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 2.53% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY | 1820 E. 1ST STREET SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $421 | — | $421 | 0.27% |
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 | 2,419 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,430 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,419 | $328K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,235 | $773K |
| Long-term disability | STANDARD INSURANCE COMPANY | 2,225 | $143K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,419 | $328K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,419 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.