| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CALIFORNIA BANKERS INS./BANKER BEN.3 | 1303 J STREET SACRAMENTO, CA 95814 | UNUM LIFE INSURANCE | — | — | $0 | 0.00% |
| CALIFORNIA BANKERS INS./BANKER BEN.3 | 1303 J STREET SACRAMENTO, CA 95814 | UNUM LIFE INSURANCE CO. | — | — | $0 | 0.00% |
| ACSIA PARTNERS LLC3 | 6201 PRESIDENTIAL COURT FORT MEYERS, FL 33919 | LIFESECURE | — | — | $0 | 0.00% |
| ACSIA PARTNERS LLC3 | 6201 PRESIDENTIAL COURT FORT MEYERS, FL 33919 | LIFESECURE | — | — | $0 | 0.00% |
| ACSIA PARTNERS LLC3 | 6201 PRESIDENTIAL COURT FORT MEYERS, FL 33919 | LIFESECURE | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIS BANKER BENEFITS EIN 94-3091487 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1303 J STREET SUITE 600 SACRAMENTO, CA 95814 | $73K |
| DUANE MORRIS EIN 23-1392502 ATTORNEY | Legal Service code 29 | 30 SOUTH 17TH STREET PHILADELPHIA, PA 191034196 | $49K |
| COMYNS,SMITH,MCCLEARY & DEAVER, LLP EIN 68-0307221 ACCOUNTANT | Accounting (including auditing) Service code 10 | 1777 BOTELHO DRIVE SUITE 350 WALNUT CREEK, CA 94596 | $22K |
| US BANK EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 1555 N RIVERCENTER DR STE300 MILWAUKEE, WI 53212 | $18K |
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 | 91 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 91 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNUM LIFE INSURANCE | 16 | $28K |
| Other(4 contracts, 2 carriers) | LIFESECURE | 23 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 23 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.