| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | LOCKBOX 740659 LOS ANGELES, CA 90074 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 7.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $5K | $0 | $5K | 4.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 100 FRONT STREET, SUITE 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 1.86% |
| BRADAWN INSURANCE SERVICES, INC.3 | 500 LA TERRAZA BOULEVARD, SUITE 102 ESCONDIDO, CA 92025 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $790 | $1 | $791 | 4.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | MANHATTANLIFE | $158 | $0 | $158 | 3.78% |
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 | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 396 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 335 | $4.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 451 | $267K |
| Vision | VISION SERVICE PLAN | 277 | $41K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 391 | $112K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 391 | $112K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 335 | $4.7M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 391 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.