| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $10K | $22K | 15.68% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1K | $1K | 1.01% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20K | $0 | $20K | 15.68% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 6.06% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $4K | $4K | 2.74% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $625 | $625 | 0.48% |
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $4K | $11K | 21.84% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97109 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1K | $1K | 1.98% |
| PCF INSURANCE SERVICES OF THE WEST3 | 2500 W EXECUTIVE PKWY STE 200 LEHI, UT 840433858 | VISION SERVICE PLAN | $59 | $0 | $59 | 0.23% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 940405214 | VISION SERVICE PLAN | $2 | $0 | $2 | 0.01% |
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $178 | $290 | $468 | 17.57% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $17 | $17 | 0.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FOY & ASSOCIATES EIN 82-1368960 INSURANCE AGENT & BROKER | Insurance agents and brokers Service code 22 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | $205K |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 470 | $3.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 494 | $250K |
| Vision | VISION SERVICE PLAN | 176 | $25K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 168 | $931K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 168 | $627K |
| Long-term disability(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 168 | $952K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 168 | $627K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.