| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, INC. | 515 S. FLOWER STREET, 36TH FLOOR LOS ANGELES, CA 90071 | BLUE CROSS OF CALIFORNIA | $246K | $2K | $248K | 4.85% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, INC. | 515 S. FLOWER STREET, 36TH FLOOR LOS ANGELES, CA 90071 | METROPOLITAN LIFE INSURANCE COMPANY | $70K | $10K | $80K | 11.58% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | 101 S GARLAND AVE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $21K | $21K | 3.09% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, INC. | 515 S. FLOWER STREET, 36TH FLOOR LOS ANGELES, CA 90071 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | $23 | $3K | 4.85% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $503 | $3K | 13.89% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, INC. | 515 S. FLOWER STREET, 36TH FLOOR LOS ANGELES, CA 90071 | SAFEGUARD HEALTH PLANS, INC. | $2K | $422 | $3K | 11.28% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | 101 S GARLAND AVE, SUITE 203 ORLANDO, FL 32801 | SAFEGUARD HEALTH PLANS, INC. | — | $666 | $666 | 2.84% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, INC. | 515 S. FLOWER STREET, 36TH FLOOR LOS ANGELES, CA 90071 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 15.00% |
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 | 339 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 298 | $5.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 721 | $711K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 246 | $57K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 721 | $712K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 721 | $712K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 721 | $687K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 298 | $5.1M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,178 | $722K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,178 | — |
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.