| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WRAITH, SCARLETT & RANDOLPH3 | 622 MAIN STREET WOODLAND, CA 95695 | WESTERN HEALTH ADVANTAGE | $49K | — | $49K | 5.00% |
| WRAITH, SCARLETT & RANDOLPH3 | 622 MAIN STREET WOODLAND, CA 95695 | STERLING LIFE INSURANCE COMPANY | $2K | — | $2K | 1.19% |
| WRAITH, SCARLETT & RANDOLPH3 | 622 MAIN STREET WOODLAND, CA 95695 | GUARDIAN LIFE INSURANCE COMPANY | $5K | — | $5K | 17.56% |
| WRAITH, SCARLETT & RANDOLPH3 Filed as: WRAITH SCARLETT & RANDOLPH INS | 622 MAIN STREET WOODLAND, CA 95695 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 12.97% |
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 | 176 | 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) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 176 | $1.1M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 153 | $31K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $12K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY | 153 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.