| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SRVCS, INC. | — | SUN LIFE ASSURANCE COMPANY OF CANADA | $27K | — | $27K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC - TACOMA | — | DELTA DENTAL OF WASHINGTON | $12K | — | $12K | 4.64% |
| ANTIK LLC3 | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 3.92% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST HILLS INS AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 2.12% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY INC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $48 | — | $48 | 0.06% |
| ANTIK LLC3 | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 7.19% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST HILLS INS AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.79% |
| ANTIK LLC3 | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.56% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST HILLS INS AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 3.04% |
| ANTIK LLC3 | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.54% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST HILLS INS AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 2.54% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC | — | AMERITAS LIFE INSURANCE CORP. | $4K | — | $4K | 10.00% |
| ANTIK LLC3 | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 8.12% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST HILLS INS AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.68% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY INC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| ANTIK LLC3 | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 5.04% |
| WEST RIDGE INSURANCE AGENCY, INC.3 Filed as: WEST HILLS INS AGENCY LLC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $761 | — | $761 | 2.58% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL ANDERSON AGENCY INC | — | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $410K |
| AETNA BEHAVIORAL HEALTH, LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $11K |
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 | 444 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 53 | $225K |
| Dental | DELTA DENTAL OF WASHINGTON | 578 | $254K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 976 | $38K |
| Life insurance(6 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 429 | $275K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 429 | $49K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 404 | $542K |
| Other(7 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 976 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 976 | — |
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.