| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC. | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | BLUE CROSS OF CALIFORNIA | $111K | — | $111K | 5.37% |
| POMS & ASSOCIATES INSURANCE BROKERS3 Filed as: POMS & ASSOCIATES | 5700 CANOGA AVENUE, SUITE 400 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $9K | — | $9K | 0.44% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 3605 GLENWOOD AVENUE SUITE 201 RALEIGH, NC 27612 | FOUR EVER LIFE INSURANCE CO. | $154K | — | $154K | 8.00% |
| ANTHEM INSURANCE COMPANIES, INC.0 Filed as: ANTHEM INSURANCE COMPANIES | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INSURANCE CO. | — | $77K | $77K | 4.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 4480 WILLOW ROAD PLEASANTON, CA 94588 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $857 | — | $857 | 15.00% |
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 | 327 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 826 | $4.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 826 | $2.1M |
| Vision | BLUE CROSS OF CALIFORNIA | 826 | $2.1M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 826 | $2.1M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 826 | $2.1M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 826 | $2.1M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 826 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 826 | — |
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.