| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 10265 BIRMINGHAM, AL 35202 | BLUE CROSS OF CALIFORNIA | $169K | $22K | $191K | 2.84% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST. STE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $6K | $12K | 9.45% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $6K | $19K | 15.06% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $3K | $2K | $5K | 5.00% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST. STE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $5K | $15K | 14.52% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST. STE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $784 | $2K | 13.41% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $339 | — | $339 | 2.41% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 89662 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $220 | — | $220 | 1.56% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $111 | — | $111 | 0.79% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE ROAD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $32 | — | $32 | 0.23% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST. STE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $983 | $983 | $2K | 14.77% |
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 | 1,005 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,030 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1,188 | $6.7M |
| Dental | AETNA LIFE INSURANCE CO. | 175 | $28K |
| Vision | VISION SERVICE PLAN | 479 | $105K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 909 | $227K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 909 | $126K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 909 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,188 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.