| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS AGENCY INC | PO DRAWER 1189 SAN LUIS OBISPO, CA 93406 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 6.91% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INSURANCE | AGENCY, INC. PO BOX 1189 SAN LUIS OBISPO, CA 93406 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 4.90% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | SERVICES, LLC 2677 N MAIN ST, STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN, INC. | $624 | — | $624 | 1.06% |
| ASSUREDPARTNERS3 Filed as: MORRIS AND GARRITANO | INSURANCE SERVICES 1122 LAUREL LN SAN LUIS OBISPO, CA 93401 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $424 | $3K | 11.74% |
| AMWINS3 Filed as: AMWINS CONNECT INS SERVICES | ATTN VIVAN LEUS 2677 N MAIN ST, STE 800 SANTA ANA, CA 92705 | PRINCIPAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.08% |
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 | 100 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 19 | $158K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $27K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $27K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $27K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $27K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.