| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 21.78% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SEREVICES INC | 330 TRES PINOS ROAD, SUITE A1 HOLLISTER, CA 95023 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $374 | $8K | 14.52% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 1357A EAST LASSEN AVENUE CHICO, CA 95926 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $228 | $31 | $259 | 0.45% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $1K | $11K | 40.67% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SEREVICES INC | 330 TRES PINOS ROAD, SUITE A1 HOLLISTER, CA 95023 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 15.69% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 1357A EAST LASSEN AVENUE CHICO, CA 95926 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $97 | $0 | $97 | 0.37% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | PO BOX 8110 CHICO, CA 95927 | VISION SERVICE PLAN | $893 | $0 | $893 | 7.14% |
| MELANIE BRUBAKER3 Filed as: MELANIE L. BRUBAKER | 30 PHILADELPHIA DRIVE, SUITE D CHICO, CA 95973 | AFLAC | $324 | $15 | $339 | 3.97% |
| MJ INSURANCE3 Filed as: NATASHA CROSS AND VARIOUS AGENTS | 736 ANDREW DRIVE YUBA CITY, CA 95991 | AFLAC | $183 | $21 | $204 | 2.39% |
| LEFTOUT CAPITAL INC3 | 3221 COHASSETT ROAD CHICO, CA 95973 | AFLAC | $127 | $0 | $127 | 1.49% |
| LEFTOUT CAPITAL INC3 | 30 PHILADELPHIA DRIVE, SUITE D CHICO, CA 95973 | AFLAC | $79 | $8 | $87 | 1.02% |
| ADAM ANTHEN AYLWORTH3 | PO BOX 505 ENTERPRISE, UT 84725 | AFLAC | $83 | $0 | $83 | 0.97% |
| RYAN OLSON3 Filed as: RYAN T. OLSON | 1294 EAST 1ST AVENUE CHICO, CA 95926 | AFLAC | $60 | $0 | $60 | 0.70% |
| DAMON R STREETMAN3 Filed as: DAMON R. STREETMAN | 5894 WEST WILDFLOWER COURT HIGHLAND, UT 84003 | AFLAC | $51 | $0 | $51 | 0.60% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | PO BOX 2268 MERCED, CA 95344 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $601 | $0 | $601 | 11.00% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 87 | $13K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $89K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 82 | $26K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $57K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.