| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE COMPANY | $2K | $5K | $7K | 0.34% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 9.90% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 11.50% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $330 | — | $330 | 10.01% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $370 | — | $370 | 14.98% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $40 | — | $40 | 10.00% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 248 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 155 | $124K |
| Vision | AETNA LIFE INSURANCE COMPANY | 248 | $2.0M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $21K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 248 | $2.0M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.