| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT HICKS INSURANCE SERVICES INC3 | 1200 J STREET MODESTO, CA 95354 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $97K | $0 | $97K | 5.05% |
| ROBERT HICKS INSURANCE SERVICES INC3 | 1200 J STREET MODESTO, CA 95354 | KAISER FOUNDATION HEALTH PLAN INC | $40K | $0 | $40K | 3.59% |
| ROBERT HICKS INSURANCE SERVICES INC3 | 1200 J STREET MODESTO, CA 95354 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $3K | $15K | 12.03% |
| ROBERT HICKS INSURANCE SERVICES INC3 | 1200 J STREET MODESTO, CA 95354 | ANTHEM LIFE INSURANCE COMPANY | $934 | $0 | $934 | 5.06% |
| ROBERT HICKS INSURANCE SERVICES INC3 | 1200 J STREET MODESTO, CA 95354 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| ANCILARY INSURANCE SOLUTIONS3 | 555 WEST SHAW AVENUE, SUITE C1 FRESNO, CA 93704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $542 | $542 | 5.00% |
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 | 314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 317 | 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 | 240 | $3.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 182 | $127K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 277 | $1.9M |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 277 | $29K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 240 | $3.0M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 277 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.