| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMINSTRATORS INC | 721 S PARKER ST STE 300 ORANGE, CA 928684732 | UNITEDHEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 2.00% |
| LAKE FOREST INSURANCE INC.3 Filed as: LAKE FOREST INSURANCE AGE | 23052 ALICIA PKY STE H-42 MISSION VIEJO, CA 926921643 | UNITEDHEALTHCARE OF CALIFORNIA | $27K | — | $27K | 5.00% |
| LAKE FOREST INSURANCE INC.3 Filed as: LAKE FOREST INSURANCE | 23052 ALICIA PKWY MISSION VIEJO, CA 92692 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $13K | — | $13K | 9.99% |
| LAKE FOREST INSURANCE INC.3 Filed as: LAKE FOREST INS AGENCY INC | 23052 ALICIA PKWY #H423 MISSION VIEJO, CA 92692 | GUARDIAN | $12K | — | $12K | 14.20% |
| ENROLLEASE3 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | GUARDIAN | $2K | — | $2K | 2.84% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 100 | $1.1M |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 205 | $131K |
| Vision | GUARDIAN | 114 | $84K |
| Life insurance | GUARDIAN | 114 | $84K |
| Long-term disability | GUARDIAN | 114 | $84K |
| Other | GUARDIAN | 114 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.