| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KCAL HEALTH INSURANCE SERVICES3 | 2048 S HACIENDA BLVD HACIENDA HTS, CA 917454240 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 2.00% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | UNITEDHEALTHCARE INSURANCE COMPANY | $11K | — | $11K | 1.00% |
| KCAL HEALTH INSURANCE SERVICES3 | 2048 S HACIENDA BLVD HACIENDA HEIGHTS, CA 917454240 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $4K | $14K | 10.09% |
| AMWINS3 Filed as: LISI LLC DBA AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $7K | $13K | 9.71% |
| AMWINS3 Filed as: LISI LLC DBA AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | METROPOLITAN LIFE INSURANCE COMPANY | — | $17 | $17 | 0.01% |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 29 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 223 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 266 | $137K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 266 | $137K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 266 | $137K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 266 | $137K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 266 | $137K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 266 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.