| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCKMAN MITCHELL FINANCIAL SERVICES4 Filed as: BUCKMAN & MITCHELL | 575 E LOCUST AVE SUITE 204 FRESNO, CA 93720 | PAN AMERICAN LIFE INSURANCE COMPANY | — | $4K | $4K | 0.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TUCKER CHUI HEBESHA & SEYMOUR PC EIN 27-4986310 | Legal Service code 29 | 642 POLLASKY AVE CLOVIS, CA 93612 | $89K |
| FOUNDATION FOR MEDICAL CARE EIN 94-1623803 | Claims processing; Contract Administrator Service code 12 | 3335 S FAIRWAY VISALIA, CA 93277 | $21K |
| BORCHARDT CORONA & FAETH EIN 77-0314847 | Accounting (including auditing) Service code 10 | 1180 E SHAW AVE 110 FRESNO, CA 93710 | $7K |
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 | 122 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LINCOLN NATIONAL LIFE INS. | 0 | $6K |
| Stop-loss / reinsurancereinsurance | PAN AMERICAN LIFE INSURANCE COMPANY | 0 | $510K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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.