| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | PO BOX 101162 PASADENA, CA 91189 | HEALTH NET | $44 | — | $44 | 0.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $120 | $120 | 0.03% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $440 | $9K | 11.15% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DR TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 10.21% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $937 | — | $937 | 5.84% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | POST OFFICE BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $370 | — | $370 | 11.97% |
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 | 621 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 648 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 459 | $8.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,271 | $708K |
| Vision | VISION SERVICE PLAN | 503 | $84K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 621 | $457K |
| Short-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 621 | $536K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 621 | $457K |
| Prescription drug | HEALTH NET | 459 | $8.1M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 621 | $552K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,271 | — |
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.