| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 2125 YGNACIO VALLEY ROAD SUITE 200 WALNUT CREEK, CA 94598 | BLUE CROSS OF CALIFORNIA | $48K | — | $48K | 5.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $9K | $9K | 0.99% |
| ASSUREDPARTNERS3 Filed as: UNITED AGENCIES INC. | 100 N. 1ST STREET SUITE 301 GLENDALE, CA 91203 | BLUE CROSS OF CALIFORNIA | -$1 | — | -$1 | -0.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 750 THE CITY DRIVE S SUITE 450 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | $713 | $8K | 4.89% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | DBA ACENTRIA INSURANCE 4634 GULFSTARR DRIVE DESTIN, FL 32541 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $400 | $2K | 12.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT ADMIN | 721 S. PARKER STREET SUITE 300 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | $491 | $625 | $1K | 6.78% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 188 | $1.1M |
| Dental | BLUE CROSS OF CALIFORNIA | 188 | $903K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 224 | $16K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 188 | $903K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 188 | $903K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 188 | $1.1M |
| Other | BLUE CROSS OF CALIFORNIA | 188 | $903K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.