| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE HORIZON INSURANCE INC.3 Filed as: BLUE HORIZON INSURANCE INC | 3838 CAMINO DEL RIO N SAN DIEGO, CA 92108 | AETNA LIFE INSURANCE COMPANY | $16K | — | $16K | 5.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10505 SORRENTO VALLEY ROAD SAN DIEGO, CA 92121 | AETNA LIFE INSURANCE COMPANY | $1K | — | $1K | 0.45% |
| BLUE HORIZON INSURANCE INC.3 Filed as: BLUE HORIZON INSURANCE, INC. | 3838 CAMINO DEL RIO N, SUITE 315 SAN DIEGO, CA 92108 | VISION SERVICE PLAN | $739 | — | $739 | 7.56% |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 205 | $568K |
| Dental | AETNA LIFE INSURANCE COMPANY | 60 | $298K |
| Vision | VISION SERVICE PLAN | 91 | $10K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 60 | $298K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.