| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | UNITED CONCORDIA INSURANCE COMPANY | $4K | — | $4K | 10.13% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS & BROKERS | 4250 EXECUTIVE SQ, STE 250 LA JOLLA, CA 92037 | AFLAC | $7K | $24 | $7K | 17.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $3K | — | $3K | 9.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $183 | $3K | 10.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 5.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 801 S FIGUEROA ST, STE 700 LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 17.87% |
| JACQUELYN E. K. HOLDER3 Filed as: JACQUELYN E HOLDER | 8220 UNIVERSITY AVE, STE 200 LA MESA, CA 91942 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 17.59% |
| MICHELLE R BARROW3 | UNKNOWN LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $612 | — | $612 | 9.49% |
| HEATHER SIEMS3 | 8859 LASSIE LANE SAN DIEGO, CA 92123 | CONTINENTAL AMERICAN INSURANCE COMPANY | $300 | — | $300 | 4.65% |
| JD HOLDER ENTERPRISES INC3 | 8220 UNIVERSITY AVE, STE 200 LA MESA, CA 91942 | CONTINENTAL AMERICAN INSURANCE COMPANY | $258 | — | $258 | 4.00% |
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 130 | $73K |
| Vision | VISION SERVICE PLAN | 141 | $20K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 267 | $64K |
| Short-term disability | AFLAC | 54 | $38K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 267 | $25K |
| Other(3 contracts, 3 carriers) | AFLAC | 267 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.