| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BLVD IRVINE, CA 92612 | AETNA HEALTH, INC. | $34K | — | $34K | 3.23% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $25K | $867 | $25K | 2.86% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BLVD IRVINE, CA 92612 | AETNA LIFE INSURANCE CO. | $28K | — | $28K | 3.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | HARTFORD LIFE AND ACCIDENT | $23K | — | $23K | 20.59% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | -$11K | — | -$11K | -10.05% |
| EPIC3 | 1390 WILLOW PASS RD #800 CONCORD, CA 94520 | EYEMED VISION CARE | $3K | — | $3K | 12.52% |
| EPIC3 | PO BOX 102159 PASADENA, CA 91189 | EYEMED VISION CARE | $360 | — | $360 | 1.57% |
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 | 198 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 414 | $2.6M |
| Dental | AETNA LIFE INSURANCE CO. | 414 | $718K |
| Vision | EYEMED VISION CARE | 373 | $23K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 198 | $112K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 198 | $112K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 198 | $112K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 104 | $888K |
| Other | HARTFORD LIFE AND ACCIDENT | 198 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.