| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN ST 21ST FLOOR SAN FRANCISCO, CA 94105 | CALIFORNIA PHYSICIANS' SERVICE | — | $56K | $56K | 5.42% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVC LLC | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS' SERVICE | $22K | — | $22K | 2.11% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.29% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 2.96% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY #1950 ATLANTA, GA 30339 | AMERICAN FIDELITY ASSURANCE COMPANY | $405 | — | $405 | 0.34% |
| RENBERG COMPLIANCE3 Filed as: RENBERG COMPLIANCE & | INSURANCE SERVICES INC 7395 N PALM BLUFF AVE #105 FRESNO, CA 93711 | AMERICAN FIDELITY ASSURANCE COMPANY | $91 | — | $91 | 0.08% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI & ASSOC INS SVC | 3400 W MINERAL KING #B VISALIA, CA 93291 | AMERICAN FIDELITY ASSURANCE COMPANY | $84 | — | $84 | 0.07% |
| BALDWIN-GEORGENTON INS AGENCY, INC.3 Filed as: BALDWIN-GEORGENTON INS AGENCY INC | 8200 STOCKDALE HWY BAKERSFIELD, CA 93309 | AMERICAN FIDELITY ASSURANCE COMPANY | $14 | — | $14 | 0.01% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 225 NE MIZNER BLVD STE 675 BOCA RATON, FL 33432 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $9K | 12.01% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 225 NE MIZNER BLVD STE 675 BOCA RATON, FL 33432 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 19.39% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 225 NE MIZNER BLVD STE 675 BOCA RATON, FL 33432 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $596 | $2K | 14.62% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 225 NE MIZNER BLVD STE 675 BOCA RATON, FL 33432 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $608 | $2K | 19.83% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 945207924 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $215 | $1K | 11.71% |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 153 | $1.1M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $75K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 181 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $37K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 57 | $120K |
| Long-term disability(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 57 | $132K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 153 | $1.0M |
| Other(3 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 156 | $156K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.