| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 2745 W 600 N LINDON, UT 84042 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35K | $28K | $63K | 22.11% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | STE 200 1451 GRANT RD MOUNTAIN VIEW, CA 94040 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $5K | $17K | 5.86% |
| TCS INSURANCE AGENCY INC3 | STE 340 100 SMITH RANCH RD SAN RAFAEL, CA 94903 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $15K | $23K | 17.96% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $596 | $596 | 0.47% |
| TCS INSURANCE AGENCY INC3 | STE 340 100 SMITH RANCH RD SAN RAFAEL, CA 94903 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $255 | $343 | $598 | 22.03% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $5 | $5 | 0.18% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY, LLC | PO BOX 9101 PLAINVIEW, NY 11803 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $304 | $186 | $490 | 18.55% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY, LLC | 1250 CAPITAL OF TEXAS HWY BLDG 2 STE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $45 | $45 | 1.70% |
| NO BROKERS FOR THIS POLICY3 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY, LLC | PO BOX 9101 PLAINVIEW, NY 11803 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $174 | $90 | $264 | 18.98% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TEXAS HWY BLDG 2 STE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $28 | $28 | 2.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST EIN 82-1368960 3 | Insurance brokerage commissions and fees; Participant communication; Consulting (general); Consulting fees Service code 16 | 21300 VICTORY BLVD, SUITE 700 WOODLAND HILLS, CA 91367 | $215K |
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 | 294 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 296 | $37K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 294 | $995K |
| Long-term disability(7 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 294 | $1.4M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 294 | $995K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.