| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED AMG PARTNERS INS. SERVICES3 | 2600 MICHELSON DRIVE, SUITE 1700 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $35K | $0 | $35K | 4.15% |
| GROSSLIGHT INSURANCE INC.3 | PO BOX 24946 LOS ANGELES, CA 90024 | BLUE CROSS OF CALIFORNIA | $2K | $0 | $2K | 0.28% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN SERVICES | 6200 CANOGA AVENUE, SUITE 300 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $1K | $0 | $1K | 0.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN INS. ADMINISTRATORS | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $769 | $0 | $769 | 0.09% |
| UNITED AMG PARTNERS INS. SERVICES3 | 2600 MICHELSON DRIVE, SUITE 1700 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $691 | $0 | $691 | 12.26% |
| GROSSLIGHT INSURANCE INC.3 | 1333 WESTWOOD BOULEVARD LOS ANGELES, CA 90024 | METROPOLITAN LIFE INSURANCE COMPANY | $176 | $0 | $176 | 3.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS INC. | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | METROPOLITAN LIFE INSURANCE COMPANY | -$2K | $0 | -$2K | -30.13% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 183 | $853K |
| Dental | BLUE CROSS OF CALIFORNIA | 183 | $853K |
| Vision | BLUE CROSS OF CALIFORNIA | 183 | $853K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 183 | $853K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 9 | $6K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 183 | $853K |
| Other | BLUE CROSS OF CALIFORNIA | 183 | $853K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.