| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOLE AND SONS INC3 | P.O. BOX 400 BONITA, CA 91908 | CALIFORNIA PHYSICIANS SERVICE | $24K | — | $24K | 2.50% |
| JON DAVIS3 Filed as: JON W. DAVIS | 3131 CAMINO DEL RIO NORTH 1250 SAN DIEGO, CA 92108 | CALIFORNIA PHYSICIANS SERVICE | $24K | — | $24K | 2.50% |
| SFGA INSURANCE MARKETING3 | 2140 PROFESSIONAL DRV STE 150 ROSEVILLE, CA 95661 | CALIFORNIA PHYSICIANS SERVICE | $19K | — | $19K | 2.00% |
| JON DAVIS3 Filed as: JON W. DAVIS | STRATEGIC WEALTH ASSOCIATE 5050 N 40TH STREET,STE #100 PHOENIX, AZ 850182146 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $0 | $7K | 6.64% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: NEW ENGLAND FINANCIAL | 1095 AVENUE OF AMERICAS NEW YORK, NY 100366797 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 5.17% |
| JON DAVIS3 Filed as: JON W. DAVIS | STRATEGIC WEALTH ASSOCIATE 5050 N. 40TH STREET, #100 PHOENIX, AZ 850182146 | SAFEGUARD HEALTH PLANS INC | $1K | $0 | $1K | 7.76% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: NEW ENGLAND FINANCIAL/NEW ENGLAND | 1095 AVENUE OF THE AMERICAS NEW YORK, NY 100366797 | SAFEGUARD HEALTH PLANS INC | $0 | $1K | $1K | 6.49% |
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 | 142 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 275 | $959K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 301 | $117K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 301 | $98K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 301 | $98K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 275 | $959K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 301 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.