| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | PROVIDENCE HEALTH PLAN | $7K | — | $7K | 2.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | DELTA DENTAL OF KANSAS, INC. | $411 | — | $411 | 2.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $594 | — | $594 | 14.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $508 | — | $508 | 13.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $421 | — | $421 | 14.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | VISION SERVICE PLAN | $295 | — | $295 | 10.01% |
No Schedule C service providers reported on this filing.
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 93 | $229K |
| Dental | DELTA DENTAL OF KANSAS, INC. | 92 | $18K |
| Vision | VISION SERVICE PLAN | 81 | $3K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $3K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $4K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $4K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.