| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 330 TRES PINOS ROAD, SUITE A1 HOLLISTER, CA 95023 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $362 | $5K | 7.79% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.69% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A EAST LASSEN AVENUE CHICO, CA 95973 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $756 | $132 | $888 | 1.43% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | PO BOX 255188 SACRAMENTO, CA 95865 | HEALTHIEST YOU | $5K | $0 | $5K | 15.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $541 | $0 | $541 | 3.14% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 330 TRES PINOS ROAD, SUITE A1 HOLLISTER, CA 95023 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $263 | $0 | $263 | 1.53% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A EAST LASSEN AVENUE CHICO, CA 95973 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $98 | $0 | $98 | 0.57% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | PO BOX 8110 CHICO, CA 95927 | VISION SERVICE PLAN | $796 | $0 | $796 | 6.94% |
| MELANIE BRUBAKER3 | 4211 LEFTOUT LANE, SUITE 130 CHICO, CA 95973 | AFLAC | $208 | $0 | $208 | 4.31% |
| LEFTOUT CAPITAL INC3 | 1053 VILLAGE LANE CHICO, CA 95926 | AFLAC | $131 | $0 | $131 | 2.71% |
| ADAM ANTHEN AYLWORTH3 Filed as: ADAM AYLWORTH | PO BOX 505 ENTERPRISE, UT 84725 | AFLAC | $42 | $0 | $42 | 0.87% |
| RYAN OLSON3 | 1294 EAST 1ST AVENUE CHICO, CA 95926 | AFLAC | $37 | $0 | $37 | 0.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: MATTHEW BROWN | 1259 LOOP 337, SUITE 200 NEW BRAUNFELS, TX 78130 | AFLAC | $22 | $0 | $22 | 0.46% |
| MJ INSURANCE3 Filed as: DAMON STREETMAN AND VARIOUS AGENTS | 5894 WEST WILDFLOWER COURT HIGHLAND, UT 84003 | AFLAC | $16 | $0 | $16 | 0.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: MATTHEW BROWN | 1919 FAIRMONT AVENUE SW SEATTLE, WA 98126 | AFLAC | $9 | $0 | $9 | 0.19% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHIEST YOU | 170 | $32K |
| Vision | VISION SERVICE PLAN | 90 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $79K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 43 | $17K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $62K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 170 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.