| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | CIGNA | $11K | $0 | $11K | 15.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | CIGNA | $11K | $0 | $11K | 15.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 950622033 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 13.26% |
| PACIFIC ADVISORS LLC3 | 2855 MICHELLE DR SUITE 320 IRVINE, CA 92606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $70 | $0 | $70 | 0.26% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | CIGNA | $3K | $0 | $3K | 15.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | VISION SERVICE PLAN | $159 | $0 | $159 | 1.45% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE, STR 200 SANTA CRUZ, CA 95062 | CIGNA | $40 | $0 | $40 | 14.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 FEES - MEDICAL | Participant communication; Named fiduciary; Other services; Non-monetary compensation; Claims processing; Contract Administrator; Float revenue; Direct payment from the plan Service code 12 | — | $411K |
| PROGRESSIVE BENEFIT GROUP EIN 59-1031071 FEES - DENTAL | Claims processing Service code 12 | 9035 SOQUEL AVE #200 SANTA CRUZ, CA 95062 | $187K |
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 | 295 | 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) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 259 | $849K |
| Vision | VISION SERVICE PLAN | 258 | $11K |
| Life insurance | CIGNA | 295 | $74K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 295 | $49K |
| Long-term disability | CIGNA | 295 | $73K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 295 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.