| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC. | 100 GALLERIA PARKWAY, SUITE 600 ATLANTA, GA 30339 | BLUE CROSS OF CALIFORNIA | $27K | — | $27K | 4.49% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC. | 1855 W. STATE ROAD, SUITE 434 LONGWOOD, FL 32750 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $3K | $15K | 13.51% |
| BARBARA J. BUSHMAN3 | 1921 BLAIR COURT BEL AIR, MD 21015 | AFLAC | $519 | — | $519 | 4.83% |
| PATRICIA DOXZEN3 Filed as: PATRICIA L. DOXZEN | 11504 SAINT DAVIDS LANE LUTHERVILLE, MD 21093 | AFLAC | $233 | — | $233 | 2.17% |
| DAVID SAOMARCOS3 Filed as: DAVID J. SAOMARCOS | 9320 CARMEL MOUNTAIN RD., STE. I SAN DIEGO, CA 92129 | AFLAC | $207 | — | $207 | 1.93% |
| ERIC M SILVERMAN3 Filed as: ERIC M. SILVERMAN | 1423 MARTIN MEADOWS DRIVE FALLSTON, MD 21047 | AFLAC | $193 | — | $193 | 1.80% |
| LIANE MCDONNELL3 Filed as: LIANE M. MCDONNELL | 8502 DRUMWOOD ROAD TOWNSON, MD 21286 | AFLAC | $136 | — | $136 | 1.27% |
| DAVID MORNINGSTAR3 | 11285 DOVEDALE COURT, 2ND FLOOR MARRIOTSVILLE, MD 21104 | AFLAC | $26 | — | $26 | 0.24% |
| EDWIN VEGA3 | 134 PINECOVE AVE. ODENTON, MD 21113 | AFLAC | $10 | — | $10 | 0.09% |
| INSURANCE OFFICE OF AMERICA3 | 4370 LA JOLLA VILLAGE DR., STE. 600 SAN DIEGO, CA 92122 | GERBER LIFE INSURANCE CO. (MES VISION) | $618 | — | $618 | 9.84% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC. | 1855 W. STATE ROAD, SUITE 434 LONGWOOD, FL 32750 | SAFEGUARD HEALTH PLANS, INC. | $575 | $200 | $775 | 12.43% |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 61 | $608K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $117K |
| Vision | GERBER LIFE INSURANCE CO. (MES VISION) | 38 | $6K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $111K |
| Short-term disability | AFLAC | 10 | $11K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $111K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 61 | $608K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.