| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DR SUITE 1016 ROCKLIN, CA 95677 | CALIFORNIA CHOICE | $97K | — | $97K | 5.00% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 2677 N MAIN STREET SUITE 800 SANTA ANA, CA 92705 | CALIFORNIA CHOICE | $35K | — | $35K | 1.78% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DR. SUITE 1016 ROCKLIN, CA 95677 | DELTA DENTAL OF CALIFORNIA | $16K | — | $16K | 9.99% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DR. SUITE 1024 ROCKLIN, CA 95677 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 9.18% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST SUITE 800 SANTA ANA, CA 927056687 | PRINCIPAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.59% |
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 | 283 | 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) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 168 | $1.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 374 | $158K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 307 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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.