| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL B. KELLY INSURANCE3 | P. O. BOX 222634 CARMEL, CA 939222634 | METROPOLITAN LIFE INSURANCE COMPANY | $42K | — | $42K | 9.90% |
| AMWINS3 Filed as: LISI, LLC | 1600 W. HILLSDALE BLVD., #201 SAN MATEO, CA 944023766 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $2K | $23K | 5.53% |
| MICHAEL B. KELLY INSURANCE3 | P. O. BOX 222634 CARMEL, CA 939222263 | VISION SERVICE PLAN | $2K | — | $2K | 3.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RELIASTAR LIFE INSURANCE CO EIN 41-0451140 STOP LOSS | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 3702 PAYSPHERE CIRCLE CHICAGO, IL 606740037 | $629K |
| MICHAEL B. KELLY INSURANCE EIN 30-0540100 BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | P. O. BOX 222634 CARMEL, CA 93922 | $140K |
| COASTAL TPA EIN 77-0523382 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | P. O. BOX 80308 SALINAS, CA 93912 | $120K |
| ANTHEM BLUE CROSS EIN 95-3760980 CARRIER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | P. O. BOX 511300 LOS ANGELES, CA 90051 | $84K |
| ASPIRE HEALTH PLAN EIN 46-1567681 TPA | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 10 RAGSDALE DR STE 101 MONTEREY, CA 93940 | $8K |
| THE PHIA GROUP EIN 04-3504115 CARRER | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $5K |
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 | 395 | 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) | 395 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 898 | $420K |
| Vision | VISION SERVICE PLAN | 395 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 898 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.