| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MATRIX INSURANCE AGENCY3 Filed as: MATRIX GROUP INSURANCE AGENCY | 42840 CHRISTY ST STE 107 FREMONT, CA 94538 | UNITED HEALTHCARE INSURANCE COMPANY | $42K | $0 | $42K | 3.00% |
| MATRIX INSURANCE AGENCY3 Filed as: MATRIX GROUP INSURANCE AGENCY | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | $0 | $10K | 3.00% |
| MATRIX GROUP INS AGENCY3 | 42840 CHRISTY ST. STE 107 FREMONT, CA 94538 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 14.46% |
| MATRIX INSURANCE AGENCY3 | 42840 CHRISTY ST STE 107 FREMONT, CA 94538 | VISION SERVICE PLAN | $588 | $0 | $588 | 3.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX INSURANCE AGENCY ADMINISTRATOR | Contract Administrator Service code 13 | 42840 CHRISTY ST STE 107 FREMONT, CA 94538 | $57K |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 219 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $34K |
| Vision | VISION SERVICE PLAN | 87 | $18K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $34K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $34K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
No prospect flags tripped on this filing.