| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | CALIFORNIACHOICE | $70K | — | $70K | 4.98% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $6K | — | $6K | 11.17% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.13% |
| BENNIE INSURANCE, LLC3 | 700 CANAL ST., STE. 1 STAMFORD, CT 06902 | AETNA LIFE INSURANCE COMPANY | $368 | — | $368 | 0.70% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $256 | $2K | 11.75% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $195 | $2K | 16.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES EIN 33-0449333 CONTRACTED THIRD PARTY AD | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $11K |
| AFFORDABLE BENEFIT CHOICES EIN 66-0833161 NONE | Insurance agents and brokers; Contract Administrator; Direct payment from the plan; Insurance brokerage commissions and fees Service code 13 | — | $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 | 201 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 201 | $1.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 48 | $52K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $26K |
| Prescription drug | CALIFORNIACHOICE | 201 | $1.4M |
| Other(3 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 123 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.