| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE SUTTON & CO. INS. INC. | PO BOX 70 SANTA MONICA, CA 90406 | BLUE OF CALIFORNIA | $27K | — | $27K | 7.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES | PO BOX 5099 TWIN FALLS, ID 83303 | PACIFIC SOURCE HEALTH PLANS | $506 | — | $506 | 1.34% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INSURANCE, INC. | PO BOX 70 SANTA MONICA, CA 90406 | AMERITAS | $309 | — | $309 | 10.02% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INS INC. | PO BOX 70 SANTA MONICA, CA 90405 | SAFEGUARD HEALTH PLANS, INC. | $105 | — | $105 | 9.45% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INS INC. | PO BOX 70 SANTA MONICA, CA 90403 | METROPOLITAN LIFE INS CO | $6K | $30 | $6K | — |
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 | 645 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 645 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA | 551 | $4.7M |
| Dental(4 contracts, 4 carriers) | CIGNA | 551 | $4.2M |
| Vision(2 contracts, 2 carriers) | BLUE OF CALIFORNIA | 37 | $351K |
| Prescription drug | BLUE OF CALIFORNIA | 26 | $348K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.