| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST. STE 2400 SAN FRANCISCO, CA 94104 | UNIMERICA LIFE INSURANCE COMPANY | $147K | — | $147K | 5.00% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 232017 PLEASANT HILL, CA 94523 | STANDARD INSURANCE COMPANY | $24K | — | $24K | 2.03% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | STANDARD INSURANCE COMPANY | — | $12K | $12K | 1.04% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 232017 PLEASANT HILL, CA 94523 | STANDARD INSURANCE COMPANY | $15K | — | $15K | 1.81% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | STANDARD INSURANCE COMPANY | — | $12K | $12K | 1.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 743376 LOS ANGELES, CA 90074 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29K | $43K | $72K | 21.04% |
| 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 | $45K | $9K | $54K | 15.72% |
| 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 | — | $36K | $36K | 10.60% |
| LOCKTON COMPANIES, LLC3 | 444 W 47TH STREET, SUITE 900 KANSAS CITY, MO 641121905 | FEDERAL INSURANCE COMPANY | $4K | $837 | $5K | 24.03% |
| 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 | $308 | $2K | 14.22% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5668 CONCORD, CA 94524 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | $125 | $1K | 8.93% |
| 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 | — | $452 | $452 | 3.08% |
| 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 | $275 | $46 | $321 | 13.34% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5668 CONCORD, CA 94524 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $184 | $23 | $207 | 8.60% |
| 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 | — | $60 | $60 | 2.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROKERAGE CONCEPTS EIN 11-3667763 NONE | Claims processing Service code 12 | VALLEY SQUARE OFFICE PARK, BLDG. 1 512 TOWNSHIP LINE ROAD, SUITE 110 BLUE BELL, PA 19422 | $436K |
| BLUE SHIELD OF CALIFORNIA EIN 94-6077403 NONE | Employee (plan); Claims processing Service code 12 | — | $369K |
| INTEGRO USA, INC. EIN 20-2600995 NONE | Custodial (securities) Service code 19 | P.O BOX 101809 PASADENA, CA 911891809 | $277K |
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 | 1,758 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,798 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 1,762 | $1.2M |
| Short-term disability(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 98 | $358K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,737 | $825K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | BLUE SHIELD OF CA | 1,516 | $5.9M |
| Other(2 contracts, 2 carriers) | BLUE SHIELD OF CA | 1,758 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,762 | — |
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.