| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRAY & TROY INSURANCE SERVICES, INC3 Filed as: GRAY & TROY INSURANCE SERVICES | PO BOX 1648 SAN LUIS OBISPO, CA 93406 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $47K | — | $47K | 2.33% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS AGENCY | PO DRAWER 1189 SAN LUIS OBISPO, CA 11666 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $12K | — | $12K | 0.58% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $11K | — | $11K | 0.54% |
| GRAY & TROY INSURANCE SERVICES, INC3 Filed as: GRAY & TROY INSURANCE SERVICES | PO BOX 1648 SAN LUIS OBISPO, CA 93406 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $7K | — | $7K | 3.85% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 1.14% |
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 | 377 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 378 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 377 | $2.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 213 | $169K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 377 | $2.0M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 377 | $2.0M |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 377 | $2.0M |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 377 | $2.0M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 377 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.