| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | BLUE CROSS OF CALIFORNIA | $45K | — | $45K | 4.62% |
| IAG INSURANCE SERVICES3 | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 3.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | HUMANA INSURANCE COMPANY | $708 | — | $708 | 0.65% |
| CRC SWETT3 | 7230 MCGINNIS FERRY ROAD STREET SUWANEE, GA 30024 | COMBINED INSURANCE COMPANY OF AMERICA | $31K | — | $31K | 51.90% |
| VOLUNTARY BENEFIT ADVISORS3 | 1936 E. DEERE AVE., SUITE 215 SANTA ANA, CA 92705 | KANAWHA INSURANCE COMPANY | $14K | — | $14K | 30.60% |
| SWETT & CRAWFORD OF GEORGIA INC3 Filed as: SWETT & CRAWFORD OF GEORGIA INC. | 7230 MCGINNIS FERRY ROAD STREET SUWANEE, GA 30024 | KANAWHA INSURANCE COMPANY | $4K | — | $4K | 9.97% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $4K | — | $4K | 7.99% |
| VARIOUS - SEE ATTACHED3 | C/O TRANSAMERICA LIFE INS. CO. 1370 N. BREA BLVD, STE. 100 FULLERTON, CA 92835 | TRANSAMERICA LIFE INSURANCE COMPANY | $12K | — | $12K | 33.47% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | UDC DENTAL OF CALIFORNIA, INC. | $2K | — | $2K | 10.00% |
| IAG INSURANCE SERVICES3 | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 8.75% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $383 | — | $383 | 4.62% |
| IAG INSURANCE SERVICES3 | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | HUMANADENTAL INSURANCE COMPANY | $404 | — | $404 | 8.80% |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 140 | $1.1M |
| Dental(5 contracts, 5 carriers) | UNION SECURITY INSURANCE COMPANY | 73 | $87K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 138 | $46K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 140 | $1.1M |
| Other(4 contracts, 4 carriers) | COMBINED INSURANCE COMPANY OF AMERICA | 224 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.