| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BENEFITS LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $101K | — | $101K | 8.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $40K | $40K | 3.49% |
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BENEFITS LLC | P.O. BOX 1749 GILROY, CA 95021 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $12K | — | $12K | 9.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS | 721 S PARKER, #300 ORANGE, CA 92868 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $4K | $4K | 3.60% |
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BENEFITS | INSURANCE SERVICES LLC 7600 MONTEREY STREET SUITE 140 GILROY, CA 95020 | STANDARD INSURANCE COMPANY | $786 | — | $786 | 5.57% |
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BENEFITS | INSURANCE SERVICES LLC 7600 MONTEREY STREET SUITE 140 GILROY, CA 95020 | ANTHEM LIFE INSURANCE COMPANY | $176 | — | $176 | 3.43% |
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BENEFITS | INSURANCE SERVICES LLC 7600 MONTEREY STREET SUITE 140 GILROY, CA 95020 | BLUE CROSS OF CALIFORNIA | $90 | — | $90 | 5.03% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 135 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 115 | $118K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 115 | $118K |
| Life insurance(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 133 | $21K |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 135 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.