| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | PO BOX 8110 CHICO, CA 95927 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $29K | — | $29K | 4.01% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | PO BOX 8110 CHICO, CA 959278110 | AMERITAS LIFE INSURANCE CORP. | $5K | — | $5K | 10.00% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC | PO BOX 255188 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 5.55% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A E LASSEN AVE CHICO, CA 95926 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $193 | $3K | 16.25% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A E LASSEN AVE CHICO, CA 95926 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $127 | — | $127 | 1.67% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A E LASSEN AVE CHICO, CA 95926 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $170 | $21 | $191 | 11.27% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A E LASSEN AVE CHICO, CA 95926 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 1.23% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 127 | $760K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 123 | $49K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 123 | $49K |
| Life insurance(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 128 | $739K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 7 | $2K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.