| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYER CONCEPTS INS. SERVICES3 | 2505 EASTVIEW DRIVE CASTLE ROCK, CO 80104 | KAISER FOUNDATION HEALTH PLAN INC. | $80K | — | $80K | 4.93% |
| EMPLOYER CONCEPTS INS. SERVICES3 | 2505 EASTVIEW DRIVE CASTLE ROCK, CO 80104 | KAISER FOUNDATION HEALTH PLAN INC. | $33K | — | $33K | 4.89% |
| EMPLOYER CONCEPTS INS. SERVICES3 | 18022 COWAN, SUITE 225 IRVINE, CA 92623 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $18K | — | $18K | 7.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 703 PALOMAR AIRPORT RD., SUITE 330 CARLSBAD, CA 92011 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | — | $8K | $8K | 3.00% |
| EMPLOYER CONCEPTS INS. SERVICES3 | P.O. BOX 15750 IRVINE, CA 92623 | AMERITAS LIFE INSURANCE CORP. | $15K | — | $15K | 10.00% |
| EMPLOYER CONCEPTS INS. SERVICES3 | P.O. BOX 15750 IRVINE, CA 92623 | AMERITAS LIFE INSURANCE CORP. | $7K | — | $7K | 10.00% |
| VARIOUS - SEE ATTACHED3 | C/O COLONIAL LIFE AND ACCIDENT P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | $3K | $17K | 28.49% |
| EMPLOYER CONCEPTS INS. SERVICES3 | P.O. BOX 15750 IRVINE, CA 92623 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 6.90% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INS. SERVICES. | P.O. BOX 15750 IRVINE, CA 92623 | VISION SERVICE PLAN (HEALTHSMART) | $303 | — | $303 | 7.83% |
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 | 320 | 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) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 269 | $2.6M |
| Dental(3 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 194 | $250K |
| Vision(3 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 194 | $222K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 80 | $59K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 80 | $59K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 269 | $2.6M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 80 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.