| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS OF CALIFORNIA | $178K | $11K | $189K | 4.46% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES, LLC | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | $0 | $76K | $76K | 1.79% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SIMNSA | $20K | $0 | $20K | 7.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $664 | $39 | $703 | 6.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $151 | $0 | $151 | 1.33% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 1357 A EAST LASSEN AVENUE CHICO, CA 95926 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $134 | $0 | $134 | 1.18% |
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 | 623 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 632 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 878 | $4.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 878 | $4.2M |
| Vision | BLUE CROSS OF CALIFORNIA | 878 | $4.2M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 878 | $4.2M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 878 | $4.3M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 878 | $4.2M |
| Other | BLUE CROSS OF CALIFORNIA | 878 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 878 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.