| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONOVER ALMOND VALLEY INSURANCE SER3 | 2105 FOREST AVENUE SUITE 100 CHICO, CA 959287695 | SYMETRA LIFE INSURANCE COMPANY | $86K | $15K | $102K | 19.64% |
| CONOVER ALMOND VALLEY INSURANCE SER3 | 2105 FIRST AVENUE SUITE 100 CHICO, CA 95928 | QBE INSURANCE | $19K | — | $19K | 4.00% |
| CONOVER ALMOND VALLEY INSURANCE SER3 Filed as: CONOVER ALMOND VALLEY INS. SERVICES | 2105 FOREST AVENUE SUITE 100 CHICO, CA 95928 | VISION SERVICE PLAN | — | $6K | $6K | 33.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| QBE INSURANCE EIN 22-2311816 NONE | Insurance services Service code 23 | 55 WATER STREET NEW YORK, NY 10219 | $479K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 NONE | Contract Administrator Service code 13 | 220 120TH AVENUE NE BELLEVUE, WA 98005 | $270K |
| CHINOOK WINDS CASINO RESORT EIN 93-0714057 SPONSOR | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 10 | 1777 NW 44TH ST. LINCOLN CITY, OR 973675094 | $116K |
| CONOVER ALMOND VALLEY INSURANCE SER EIN 35-2524649 NONE | Insurance agents and brokers Service code 22 | 2105 FOREST AVE SUITE 100 CHICO, CA 95928 | $12K |
| BLUEBIRD CPAS EIN 26-1571066 ACCOUNTANT | Accounting (including auditing) Service code 10 | 5585 KIETZKE LANE RENO, NV 89511 | $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 | 788 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 793 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 761 | $32K |
| Vision | VISION SERVICE PLAN | 799 | $18K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 927 | $518K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 927 | $518K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 927 | $518K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 802 | $478K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 927 | — |
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.