| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURICA, INC. Filed as: INSURICA CA INSURANCE SERVICES, INC | 9600 GREAT HILLS SUITE 225W AUSTIN, TX 78759 | VISION SERVICE PLAN | $0 | $0 | $0 | 0.00% |
| THOMAS E MESTMAKER INSURANCE AGENCY3 | P.O. BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 20.00% |
| DANIEL PETREY3 | 2000 OAK STREET SUITE 100 BAKERSFIELD, CA 93301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 15.01% |
| DANIEL PETREY3 | 2000 OAK STREET SUITE 100 BAKERSFIELD, CA 93301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 15.00% |
| THOMAS E MESTMAKER INSURANCE AGENCY3 | P.O. BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $0 | $0 | 0.00% |
| DANIEL PETREY3 | 2000 OAK STREET SUITE 100 BAKERSFIELD, CA 93301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $636 | $0 | $636 | 15.70% |
| THOMAS E MESTMAKER INSURANCE AGENCY3 | P.O. BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $0 | $0 | 0.00% |
| THOMAS E MESTMAKER INSURANCE AGENCY3 | P.O. BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $798 | $0 | $798 | 19.99% |
| DANIEL PETREY3 | 2000 OAK STREET SUITE 100 BAKERSFIELD, CA 93301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $599 | $0 | $599 | 15.01% |
| THOMAS E MESTMAKER INSURANCE AGENCY3 | P.O. BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $189 | $0 | $189 | 20.00% |
| DANIEL PETREY3 | 2000 OAK STREET SUITE 100 BAKERSFIELD, CA 93301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $142 | $0 | $142 | 15.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP, LLC EIN 95-2553113 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $141K |
| BLUE CROSS EIN 95-4331852 PPO/UR VENDOR | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $91K |
| WALTER MORTENSEN INS EIN 74-3015339 96000 | Direct payment from the plan; Other fees Service code 50 | — | $0 |
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 | 409 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 409 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 409 | $249K |
| Vision | VISION SERVICE PLAN | 407 | $49K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 315 | $27K |
| Other(4 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 315 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.