| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC.5 Filed as: ANTHEM / BLUE CROSS OF CALIFORNIA | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | ANTHEM BLUE CROSS | — | $3.3M | $3.3M | — |
| INGENIO RX, INC.5 Filed as: INGENIO, RX | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | ANTHEM BLUE CROSS | — | $362K | $362K | — |
| EXPRESS SCRIPTS, INC.5 Filed as: EXPRESS SCRIPTS | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | ANTHEM BLUE CROSS | — | $355K | $355K | — |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT AND HECHT LIFE & HEALTH | 425 NE HANCOCK STREET PORTLAND, OR 97212 | ANTHEM BLUE CROSS | $182K | — | $182K | — |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 1901 MAIN STREET, SUITE 400 IRVINE, CA 92614 | UNITED HEALTHCARE OF CALIFORNIA | $16K | — | $16K | — |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE AND HEALTH | 425 NE HANCOCK STREET PORTLAND, OR 97212 | VISION SERVICE PLAN | — | $45K | $45K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 ADMINISTRATOR | Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Contract Administrator Service code 12 | — | $3.3M |
| EXPRESS SCRIPTS EIN 16-1279199 PRESCRIPTION ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Float revenue Service code 12 | — | $0 |
| INGENIOU RX EIN 82-3062245 ADMINISTRATOR | Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $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 | 3,103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 74 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 2,953 | $0 |
| Dental | ANTHEM BLUE CROSS | 2,953 | $0 |
| Vision | VISION SERVICE PLAN | 3,266 | $0 |
| Prescription drug | ANTHEM BLUE CROSS | 2,953 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,266 | — |
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."
No prospect flags tripped on this filing.