| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| XL BENEFIT INSURANCE SERVICES3 | 10471 GRANT LINE ROAD SUITE 100 ELK GROVE, CA 95624 | AMALGAMATED LIFE | $88K | — | $88K | 12.50% |
| JOHN L WENDER INSURANCE SERVICES3 Filed as: JOHN LOUIS WENDER | 755 N PEACH AVE STE I9 CLOVIS, CA 93611 | AMERITAS LIFE INSURANCE CORP | $5K | — | $5K | 20.40% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA I | 1277 TREAT BLVD STE 400 WALNUT CREEK, CA 94597 | AMERITAS LIFE INSURANCE CORP | $4K | $110 | $4K | 15.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH I EIN 95-4331852 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | MAIL DROP OH3403-A266 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $129K |
| HEALTHCOMP INC EIN 77-0385729 ASO | Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Claims processing; Consulting fees; Contract Administrator; Account maintenance fees Service code 12 | 621 SANTA FE FRESNO, CA 93721 | $106K |
| TEAMSTER ALCOHOL REHAB PROGRAM EIN 94-2875955 REHABILITATION ADMIN | Contract Administrator Service code 13 | 1620 N CARPENTER ROAD C-12 MODESTO, CA 95351 | $8K |
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 | 387 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 364 | $27K |
| Vision | VISION SERVICE PLAN | 356 | $60K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 387 | $23K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE | 351 | $702K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.