| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCKMAN MITCHELL FIN AND INS SVCES.3 Filed as: BUCKMAN-MITCHELL FIN INS SER INC | PO BOX 629 VISALIA, CA 93279 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 16.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE SHIELD EIN 94-0360524 NONE | Direct payment from the plan; Other fees Service code 50 | — | $112K |
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $91K |
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 | 384 | 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) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMIER ACCESS INSURANCE COMPANY | 510 | $16K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 512 | $51K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 20 | $8K |
| Other | HARTFORD LIFE AND ACCIDENT | 512 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 512 | — |
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.