| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICE | $1K | $159K | $160K | 1.22% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $29K | — | $29K | 2.75% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 3.03% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 3.59% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | — | $20K | 12.50% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 5.58% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE | $8K | — | $8K | 9.20% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $699 | — | $699 | 2.75% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERCER HR CONSULTING EIN 13-2834414 NONE | Actuarial Service code 11 | — | $44K |
| BDO SEIDMAN LLP EIN 13-3581590 NONE | Accounting (including auditing) Service code 10 | — | $27K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $10K |
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 | 677 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 702 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 708 | $13.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 645 | $1.1M |
| Vision(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,785 | $13.2M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 790 | $265K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 167 | $89K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 390 | $164K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 708 | $13.1M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 790 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,785 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.