| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | BLUE CROSS OF CALIFORNIA | $113K | $0 | $113K | 4.00% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | PREMIER ACCESS INSURANCE COMPANY | $23K | $0 | $23K | 12.58% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 15.00% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | VISION SERVICE PLAN | $3K | $0 | $3K | 10.00% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | — |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $365 | $0 | $365 | — |
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 | 240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 585 | $2.8M |
| Dental(3 contracts, 3 carriers) | PREMIER ACCESS INSURANCE COMPANY | 556 | $182K |
| Vision | VISION SERVICE PLAN | 175 | $32K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $83K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 585 | $2.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 585 | — |
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.