| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MANIACI INSURANCE SERVICES, INC.3 | 500 SILVER SPUR ROAD, SUITE 121 PALOS VERDES, CA 90275 | HEALTH NET | $19K | $0 | $19K | 3.96% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVCS, LLC | 500 SILVER SPUR ROAD, SUITE 121 ROLLING HILLS ESTATES, CA 90275 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $683 | $3K | 13.05% |
| TRUE NETWORK ADVISORS3 | 1513 AMBER LANE GUNTERSVILLE, AL 35976 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $57 | $57 | 0.25% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVCS, LLC | PO BOX 750004 PETALUMA, CA 94975 | CALIFORNIA DENTAL NETWORK, INC. | $1K | $0 | $1K | 10.00% |
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 | 85 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 83 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 74 | $473K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 109 | $33K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 109 | $23K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 109 | $23K |
| Prescription drug | HEALTH NET | 74 | $473K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 109 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.