| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK J MATSOCK3 Filed as: MARK MATSOCK | 2400 EAST ARIZONA BILTMORE CIRCLE SUITE 1100 PHOENIX, AZ 85016 | KAISER FOUNDATION HEALTH PLAN INC | $28K | — | $28K | 4.80% |
| MARK J MATSOCK3 Filed as: MARK J. MATSOCK & ASSOC, INC. | 2400 EAST ARIZONA BILTMORE CIRCLE SUITE 1100 PHOENIX, AZ 85016 | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | $17K | — | $17K | 8.30% |
| BENEFITS AMERICA INS. SVCS., LLC3 Filed as: BENEFITS AMERICA INS SVCS LLC | — | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 2.50% |
| BETH LUANNE KIMBROUGH3 Filed as: BETH COOPER | — | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 2.16% |
| UNISOURCE INSURANCE SERVICES, INC.3 Filed as: UNISOURCE INSURANCE SVCS INC | — | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 1.15% |
| SFBAG EMPLOYEE BENEFIT INS. SVCS.3 Filed as: SFBAG EMPL BENEFIT INS SVCS | — | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 0.99% |
| MG BENEFITS CONSULTING GROUP LLC3 Filed as: HR BENEFITS CONSULTING | — | DELTA DENTAL OF CALIFORNIA | $868 | — | $868 | 0.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA INC | — | DELTA DENTAL OF CALIFORNIA | $562 | — | $562 | 0.44% |
| USI INSURANCE SERVICES LLC3 | — | DELTA DENTAL OF CALIFORNIA | $327 | — | $327 | 0.25% |
| DAVID J MCCLELLAN3 Filed as: DAVID BOHMAN | — | DELTA DENTAL OF CALIFORNIA | $277 | — | $277 | 0.22% |
| CLAREMONT BUSINESS GROUP3 Filed as: CLAREMONT BUSINESS GROUP INC | — | DELTA DENTAL OF CALIFORNIA | $255 | — | $255 | 0.20% |
| THE JAMES B OSWALD COMPANY3 Filed as: TAYLOR BENEFITS INSURANCE AGENCY IN | — | DELTA DENTAL OF CALIFORNIA | $163 | — | $163 | 0.13% |
| MISSION EMPLOYER SOLUTIONS3 Filed as: MISSION COUNTIES INSURANCE AGENCY I | — | DELTA DENTAL OF CALIFORNIA | $163 | — | $163 | 0.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | — | DELTA DENTAL OF CALIFORNIA | $160 | — | $160 | 0.12% |
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GRP BENEFITS & INS SVCS | — | DELTA DENTAL OF CALIFORNIA | $105 | — | $105 | 0.08% |
| WEAVER BROS INSURANCE3 Filed as: WEAVER & ASSOC INSU AGENTS | — | DELTA DENTAL OF CALIFORNIA | $62 | — | $62 | 0.05% |
| EXECUTIVE FINANCIAL BENE-FACTS INC3 Filed as: EXECUTIVE BENEFITS INSURANCE AGENCY | — | DELTA DENTAL OF CALIFORNIA | $46 | — | $46 | 0.04% |
| QSR INSURANCE AGENCY INC.3 Filed as: QSR INSURANCE AGENCY INC | — | DELTA DENTAL OF CALIFORNIA | $36 | — | $36 | 0.03% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | — | DELTA DENTAL OF CALIFORNIA | $22 | — | $22 | 0.02% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED LTC INS SVCS LLC | — | DELTA DENTAL OF CALIFORNIA | $15 | — | $15 | 0.01% |
| WEAVER BROS INSURANCE3 Filed as: WEAVER & ASSOC INC INS AGENTS & BRO | — | DELTA DENTAL OF CALIFORNIA | $12 | — | $12 | 0.01% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES | 2400 EAST ARIZONA BILTMORE CIRCLE PHOENIX, AZ 85016 | MEDIEXCEL HEALTH PLAN | $6K | — | $6K | 5.33% |
| MARK METTILLE3 Filed as: MARK J MATSOCK ASSOCIATES INC | 2400 EAST ARIZONA BILTMORE CIRCLE SUITE 1100 PHOENIX, AZ 85016 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 10.16% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES | — | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 4.00% |
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 | 440 | 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) | 440 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 90 | $682K |
| Dental(3 contracts, 2 carriers) | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 383 | $357K |
| Vision | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 355 | $200K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 786 | $86K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 786 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 786 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.