| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 232017 PLEASANT HILL, CA 94523 | STANDARD INSURANCE COMPANY | $72K | — | $72K | 5.00% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 232017 PLEASANT HILL, CA 94523 | STANDARD INSURANCE COMPANY | $43K | — | $43K | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 743376 LOS ANGELES, CA 90074 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $17K | $27K | 33.69% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP | SOUTHEAST INC. 55 BROADWAY SUITE 701 NEW YORK, NY 10006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $22K | $22K | 28.53% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP | SOUTHEAST INC. 40 WALL STREET SUITE 1304 NEW YORK, NY 10005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $3K | $17K | 22.01% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TEXAS HWY BUILDING 2 SUITE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $8K | $8K | 9.52% |
| LOCKTON COMPANIES, LLC3 | 444 W 47TH STREET, SUITE 900 KANSAS CITY, MO 641121905 | FEDERAL INSURANCE COMPANY | $3K | $547 | $3K | 17.95% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 743376 LOS ANGELES, CA 90074 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | $2K | $4K | 33.80% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP | SOUTHEAST INC. 55 BROADWAY SUITE 701 NEW YORK, NY 10006 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $3K | $3K | 28.62% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP | SOUTHEAST INC. 40 WALL STREET SUITE 1304 NEW YORK, NY 10005 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $475 | $3K | 22.07% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TEXAS HWY BLDG 2 SUITE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $1K | $1K | 9.54% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 743376 LOS ANGELES, CA 90074 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $273 | $494 | $767 | 32.90% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP | 55 BROADWAY, SUITE 701 NEW YORK, NY 10006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $645 | $645 | 27.67% |
| NFP INSURANCE SERVICES INC3 Filed as: MANAGEMENT COMPENSATION GROUP | SOUTHEAST INC. 40 WALL STREET SUITE 1304 NEW YORK, NY 10005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $409 | $95 | $504 | 21.62% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 CAPITAL OF TEXAS HWY BUILDING 2 SUITE 125 AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $218 | $218 | 9.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROKERAGE CONCEPTS EIN 11-3667763 NONE | Claims processing Service code 12 | — | $566K |
| BLUE SHIELD OF CALIFORNIA EIN 94-6077403 NONE | Employee (plan); Claims processing Service code 12 | — | $388K |
| INTEGRO USA, INC. EIN 20-2600995 NONE | Custodial (securities) Service code 19 | — | $233K |
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 | 1,549 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 57 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,606 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 1,549 | $1.4M |
| Short-term disability(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 52 | $93K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,547 | $865K |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY | 1,362 | $2.6M |
| Other | FEDERAL INSURANCE COMPANY | 1,601 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,601 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.