| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 2400 KATELLA AVE STE 1100 ANAHEIM, CA 92806 | BLUE SHIELD OF CALIFORNIA, CALIFORNIA PHYSICIAN'S SERVICE | $60K | — | $60K | 5.00% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA, CALIFORNIA PHYSICIAN'S SERVICE | $24K | — | $24K | 2.00% |
| BB&T LIBERTY BENEFIT INS SVS3 Filed as: BB&T-LIBERTY BENEFIT INSURANCE SVCS | 5446 THORNWOOD DRIVE IRVINE, CA 95123 | PREMIER ACCESS INSURANCE COMPANY | $4K | — | $4K | 3.03% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 5446 THORNWOOD DRIVE SUITE 200 SAN JOSE, CA 95123 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 5446 THORNWOOD DRIVE SUITE 200 SAN JOSE, CA 95123 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 5446 THORNWOOD DRIVE SUITE 200 SAN JOSE, CA 95123 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 750 B STREET SUITE 2400 SAN DIEGO, CA 921012476 | VISION SERVICE PLAN | $832 | — | $832 | 6.77% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA, INC. | 5446 THORNWOOD DRIVE SUITE 200 SAN JOSE, CA 95123 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $730 | — | $730 | 14.99% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA, CALIFORNIA PHYSICIAN'S SERVICE | 226 | $1.2M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 235 | $139K |
| Vision | VISION SERVICE PLAN | 92 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $28K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $15K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $25K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA, CALIFORNIA PHYSICIAN'S SERVICE | 226 | $1.2M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.