| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCSHERRY HUDSON & HALL3 | 575 AUTO CENTER DRIVE WATSONVILLE, CA 95076 | ANTHEM BLUE CROSS | $15K | — | $15K | 1.44% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS | 28106 AVENUE CROCKER SUITE A VALENCIA, CA 91355 | ANTHEM BLUE CROSS | — | $8K | $8K | 0.72% |
| MCSHERRY HUDSON & HALL3 | 575 AUTO CENTER DRIVE WATSONVILLE, CA 95076 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N 1ST STREET SUITE 202 SAN JOSE, CA 95112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $15 | $15 | 0.01% |
| MCSHERRY HUDSON & HALL3 | 575 AUTO CENTER DRIVE WATSONVILLE, CA 95076 | BLUE SHIELD OF CALIFORNIA | $6K | — | $6K | 5.00% |
| AMWINS3 Filed as: LISI, INC. | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $2K | — | $2K | 2.00% |
| MCSHERRY HUDSON & HALL3 | PO BOX 698 WATSONVILLE, CA 95077 | VISION SERVICE PLAN | $1K | — | $1K | 5.08% |
| MCSHERRY HUDSON & HALL3 | PO BOX 698 WATSONVILLE, CA 95077 | VISION SERVICE PLAN | $1K | — | $1K | 5.11% |
| MCSHERRY HUDSON & HALL3 | 575 AUTO CENTER DRIVE WATSONVILLE, CA 95076 | AMERICAN UNITED LIFE INSURANCE COMPANY | $3K | — | $3K | 20.00% |
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 | 227 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 217 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 362 | $151K |
| Vision(2 contracts) | VISION SERVICE PLAN | 213 | $48K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 227 | $14K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 217 | $114K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 227 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.