| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNER | 81-5191759 1540 CORNERSTONE BLVD STE 230 DAYTONA BEACH, FL 32117 | ANTHEM LIFE INSURANCE | — | $30K | $30K | 5.00% |
| RENBERG COMPLIANCE3 Filed as: RENBERG COMPLIANCE & INS SVCS | 7395 N PALM BLUFFS AVE SUITE 105 FRESNO, CA 93711 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31K | — | $31K | 13.61% |
| RENBERG COMPLIANCE3 Filed as: RENBERG COMPLIANCE & INSURANCE | SERVICES INC 7395 N PALM BLUFFS AVE #105 FRESNO, CA 93711 | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | $8K | — | $8K | 16.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $153K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Claims processing; Other services; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $118K |
| RENBERG COMPLIANCE & INSURANCE SERV EIN 77-0565110 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $90K |
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 | 333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMIER ACCESS INSURANCE COMPANY | 801 | $19K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 708 | $278K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 708 | $230K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 708 | $230K |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE | 0 | $591K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 708 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 801 | — |
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.