| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 5.10% |
| AMWINS3 Filed as: AMWINS CONNECT | 2677 N MAIN STREET SANTA ANA, CA 92705 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 3.89% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE. GRAND RAITS, MI 49503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 2.19% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING | 1301 VIRGINIA DRIVE FORT WASHINGTON, PA 19034 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 2.05% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.75% |
| BENEFITS MATCHMAKING LLC3 Filed as: BENEFITS MATCHMAKING,LLC | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $900 | $900 | 3.87% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $522 | — | $522 | 2.25% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $104 | — | $104 | 3.88% |
| BENEFITS MATCHMAKING LLC3 Filed as: BENEFITS MATCHMAKING,LLC | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $104 | $104 | 3.88% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $30 | — | $30 | 1.12% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $213 | — | $213 | 12.35% |
| BENEFITS MATCHMAKING LLC3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $71 | $71 | 4.12% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $46 | — | $46 | 2.67% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $159 | — | $159 | 11.18% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $54 | — | $54 | 3.80% |
| BENEFITS MATCHMAKING LLC3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $53 | $53 | 3.73% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | PRINCIPAL LIFE INSURANCE COMPANY | $179 | — | $179 | 16.53% |
| BENEFITS MATCHMAKING LLC3 Filed as: BENEFITS MATCHMAKING,LLC | 100 OTTAWA AVE. GRAND RAITS, MI 49503 | PRINCIPAL LIFE INSURANCE COMPANY | $45 | — | $45 | 4.16% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING | 1301 VIRGINIA DRIVE FORT WASHINGTON, PA 19034 | PRINCIPAL LIFE INSURANCE COMPANY | $25 | — | $25 | 2.31% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | $13 | — | $13 | 1.20% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $23 | — | $23 | 12.43% |
| BENEFITS MATCHMAKING LLC3 Filed as: BENEFITS MATCHMAKING,LLC | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $8 | $8 | 4.32% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5 | — | $5 | 2.70% |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 26 | $76K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 29 | $23K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 20 | $3K |
| Life insurance(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 168 | $3K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 168 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.