| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 937113602 | BLUE SHIELD OF CALIFORNIA | $21K | — | $21K | 5.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE FRESNO, CA 93711 | BLUE SHIELD OF CALIFORNIA | $13K | — | $13K | 5.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE FRESNO, CA 93711 | BLUE SHIELD OF CALIFORNIA | $13K | — | $13K | 5.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W SHAW AVE STE A FRESNO, CA 93711 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 4.58% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W SHAW AVE STE A FRESNO, CA 93711 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 4.49% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE FRESNO, CA 93711 | CHOICEBUILDER | $4K | — | $4K | 9.87% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W SHAW AVE STE A FRESNO, CA 93711 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 5.31% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 937113602 | CHOICEBUILDER | $4K | — | $4K | 9.16% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 937113602 | CHOICEBUILDER | $2K | — | $2K | 9.16% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVE., SUITE A FRESNO, CA 93711 | PAN AMERICAN LIFE INSURANCE COMPANY | $150 | — | $150 | 0.84% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICE | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 93711 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 93711 | VISION SERVICE PLAN | $979 | — | $979 | 10.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICE | 1391 W. SHAW AVENUE FRESNO, CA 93711 | VISION SERVICE PLAN | $459 | — | $459 | 10.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 93711 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $663 | — | $663 | 15.01% |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 60 | $1.4M |
| Dental(3 contracts) | CHOICEBUILDER | 68 | $104K |
| Vision(3 contracts) | VISION SERVICE PLAN | 56 | $27K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $4K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $14K |
| Prescription drug(3 contracts) | BLUE SHIELD OF CALIFORNIA | 60 | $936K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.