| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $110 | $110 | 0.03% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 S MICHIGAN AVE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $38 | $38 | 0.01% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS* | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $12K | $1K | $14K | 15.45% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DR TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $2K | — | $2K | 11.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 18101 VON KARMAN AVE SUITE 600 IRVINE, CA 92612 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $870 | — | $870 | 5.83% |
| CHARLES A WALTERS4 | 23825 N 65TH DR GLENDALE, AZ 85310 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $50 | — | $50 | 0.33% |
| MULTIPLE AGENTS*3 | POST OFFICE BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $561 | — | $561 | 9.25% |
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 | 601 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 623 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 0 | $7.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 530 | $706K |
| Vision | VISION SERVICE PLAN | 496 | $60K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 601 | $416K |
| Short-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 601 | $511K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 601 | $416K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 0 | $7.7M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 601 | $526K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 601 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.