| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL SVCS | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS' SERVICE | $22K | $0 | $22K | 2.45% |
| BILL MARR3 Filed as: BILL LEE MARR | 1451 CANDORI COURT FOLSOM, CA 95630 | CALIFORNIA PHYSICIANS' SERVICE | $3K | $0 | $3K | 0.38% |
| BLACKTAIL INSURANCE SERVICES, INC.3 | 31800 PUDDING CREEK ROAD FORT BRAGG, CA 95437 | CALIFORNIA PHYSICIANS' SERVICE | $1K | $0 | $1K | 0.13% |
| ALLIED ADMINISTRATORS3 | 501 14TH STREET, 2ND FLOOR OAKLAND, CA 94612 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 10.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL SVCS | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $390 | $23 | $413 | — |
| BILL MARR3 Filed as: BILL L. MARR | 1451 CANDORI COURT FOLSOM, CA 95630 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $150 | $0 | $150 | — |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 91 | $880K |
| Dental | DELTA DENTAL OF CALIFORNIA | 116 | $84K |
| Vision | DELTA DENTAL OF CALIFORNIA | 116 | $84K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 121 | $0 |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 91 | $880K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 121 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.