| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID J MCCLELLAN3 Filed as: DAVID G CARVER | 100 OCEANGATE BLVD STE 800 LONG BEACH, CA 90802 | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | $69K | $0 | $69K | 2.92% |
| SALLY COKER3 Filed as: SALLY INGRAM COKER | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | $30K | $60 | $30K | 1.25% |
| DAVID GEORGE CARVER3 Filed as: DAVID CARVER | 400 OCEANGATE STE 700 LONG BEACH, CA 908024306 | KAISER FOUNDATION HEALTH PLAN INC. | $42K | $0 | $42K | 2.20% |
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | $0 | $18K | 0.94% |
| DAVID GEORGE CARVER3 Filed as: DAVID CARVER | 400 OCEANGATE #700 LONG BEACH, CA 90802 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $51K | $0 | $51K | 6.98% |
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | $0 | $22K | 2.99% |
| DAVID GEORGE CARVER3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $0 | $9K | 10.00% |
| DAVID GEORGE CARVER3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 10.00% |
| DAVID GEORGE CARVER3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 10.00% |
| THE CHILDREN'S CLINIC3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $599 | $0 | $599 | 7.00% |
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $257 | $0 | $257 | 3.00% |
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 | 365 | 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) | 365 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | 314 | $4.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 305 | $745K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 305 | $736K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 365 | $88K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 365 | $79K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | 145 | $2.4M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 365 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.