| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | PO BOX 255188 SACRAMENTO, CA 95865 | CYPRESS DENTAL ADMINISTRATORS | $7K | $0 | $7K | 4.61% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 330 TRES PINOS ROAD, SUITE A1 HOLLISTER, CA 95023 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $772 | $7K | 15.43% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 80 | $170K |
| Dental | CYPRESS DENTAL ADMINISTRATORS | 144 | $152K |
| Vision | CYPRESS DENTAL ADMINISTRATORS | 144 | $152K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 175 | $44K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 80 | $170K |
| Other(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 175 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.