| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | CALIFORNIA PHYSICIANS SERVICE | — | $130K | $130K | 5.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 701 S PARKER STREET ORANGE, CA 92868 | CALIFORNIA PHYSICIANS SERVICE | — | $52K | $52K | 2.11% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | BLUE CARE NETWORK OF MICHIGAN | $21K | — | $21K | 3.46% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 5.15% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | — | $12K | 11.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S. PARKER STREET ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | — | $8K | $8K | 7.47% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $518 | $12K | 15.08% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 701 S PARKER STREET ORANGE, CA 92868 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | — | $237 | $237 | 2.31% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | CALIFORNIA DENTAL NETWORK, INC. | $842 | — | $842 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S. PARKER STREET ORANGE, CA 92868 | CALIFORNIA DENTAL NETWORK, INC. | $589 | — | $589 | 7.00% |
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 | 352 | 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) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 262 | $3.1M |
| Dental(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $261K |
| Vision(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $252K |
| Life insurance(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $239K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 84 | $82K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 262 | $3.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.