| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED BENEFITS GROUP LLC3 Filed as: DIVERSIFIED BENEFITS SERVICES | 139 W. SHAW, SUITE A FRESNO, CA 937113602 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 1391 W. SHAW AVENUE, SUITE A FRESNO, CA 93711 | SUN LIFE FINANCIAL | $2K | — | $2K | 12.35% |
| ACRISURE LLC3 Filed as: DIBUDUO & DEFENDIS INSURANCE | 6873 N. WEST, #101 FRESNO, CA 93711 | SUN LIFE FINANCIAL | $323 | — | $323 | 2.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS LIFE & HEALTH EIN 95-4331852 FEES | Other services; Claims processing; Contract Administrator Service code 12 | — | $35K |
| E.B.A. & M. CORPORATION EIN 95-2881702 TPA | Claims processing; Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $35K |
| DIVERSIFIED BENEFIT SERVICES EIN 94-2869219 BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $15K |
| DIBIDUO & DEFENDIS INSURANCE EIN 94-1530342 BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE FINANCIAL | 126 | $13K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.