| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOWERMASTER & ASSOCIATES INSURANCE3 Filed as: BOWERMASTER AND ASSOCIATES INS. | 10805 HOLDER STREET, SUITE 350 CYPRESS, CA 90630 | CALIFORNIA PHYSICIANS SERVICE | $0 | $38K | $38K | 5.31% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 10805 HOLDER STREET, SUITE 350 CYPRESS, CA 90630 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 8.72% |
| IPG PORTLAND, LLC3 Filed as: IPG PORTLAND LLC | 12042 SE SUNNYSIDE, SUITE 313 CLACKAMAS, OR 97015 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $3K | $45 | $3K | 3.55% |
| BOWERMASTER & ASSOCIATES INSURANCE3 Filed as: BOWERMASTER AND ASSOCIATES INS. | PO BOX 6026 CYPRESS, CA 90630 | PRINCIPAL LIFE INSURANCE COMPANY | $657 | $0 | $657 | 4.86% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY AND ASSOCIATES | 2901 WEST BELTLINE HIGHWAY SUITE 202 MADISON, WI 55713 | DELTA DENTAL OF WISCONSIN | $1K | $0 | $1K | 9.25% |
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 | 102 | 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. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 119 | $797K |
| Dental(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $160K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $75K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $88K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $88K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.