| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERED INSURANCE SOLUTIONS, INC.3 Filed as: CENTERED INSURANCE SOLUTIONS INC | — | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $50K | — | $50K | 3.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMINISTRATORS INC | 721 S PARKER STREET ORANGE, CA 92868 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $7K | $15K | $22K | 1.38% |
| CENTERED INSURANCE SOLUTIONS, INC.3 Filed as: CENTERED INSURANCE SOLUTIONS INC | 1100 FLYNN RD, SUITE 102 CAMARILLO, CA 93012 | SUN LIFE ASSURANCE COMPANY OF CANADA | $42K | $8K | $49K | 13.76% |
| CENTERED INSURANCE SOLUTIONS, INC.3 Filed as: CENTERED INSURANCE SOLUTIONS INC | 1100 FLYNN RD, SUITE 102 CAMARILLO, CA 93012 | METLIFE LEGAL PLANS | $632 | — | $632 | 14.81% |
| CENTERED INSURANCE SOLUTIONS, INC.3 Filed as: CENTERED INSURANCE SOLUTIONS INC | 1100 FLYNN RD, SUITE 102 CAMARILLO, CA 93012 | METROPOLITAN GENERAL INSURANCE COMPANY | $81 | — | $81 | 7.63% |
| STEPHANIE BERGER3 | 79 E DAILY DR #276 CAMARILLO, CA 93010 | SUN LIFE ASSURANCE COMPANY OF CANADA | $55 | — | $55 | 10.83% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 232 | $1.6M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 183 | $359K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 183 | $359K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 183 | $359K |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 183 | $360K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 183 | $359K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 183 | $365K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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.