| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 2677 ROCHELLE PLACE SIMI VALLEY, CA 93063 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | $0 | $14K | 9.81% |
| FOUNDATION RISK PARTNERS CORP3 | 25 FAIRVIEW AVE VERONA, NJ 07044 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 3.82% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC | 2677 ROCHELLE PLACE SIMI VALLEY, CA 93063 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | $0 | $15K | 16.60% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES | 4634 GULFSTARR DRIVE DESTIN, FL 32541 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.91% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 4634 GULFSTARR DRIVE DESTIN, FL 32541 | VISION SERVICE PLAN | $408 | $0 | $408 | 1.02% |
| M FINANCIAL HOLDINGS INC3 Filed as: FM FINANCIAL SERVICES INC. | 2677 ROCHELLE PLACE SIMI VALLEY, CA 93063 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $56 | $0 | $56 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $146K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $39K |
| WEX HEALTH INC EIN 06-1593514 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $8K |
| SUN LIFE ASSURANCE CO. OF CANADA EIN 38-1082080 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $5K |
| CIGNA | Other services Service code 49 | — | $0 |
| FM FINANCIAL SERVICES INC EIN 20-4510876 BROKER | Other commissions Service code 55 | — | $0 |
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 | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 325 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 320 | $40K |
| Life insurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 298 | $227K |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 298 | $227K |
| Long-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 298 | $227K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 445 | $2.0M |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 298 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 445 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.