| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALICIA SOLIS3 Filed as: ALICIA C. SOLIS | 26125 MANZANITA ST. MURIETTA, CA 92563 | UNITEDHEALTHCARE INSURANCE COMPANY | $100K | — | $100K | — |
| AMWINS3 Filed as: LISI, INC. | 1600 HILLSDALE BLVD. SAN MATEO, CA 94402 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | — | $5K | — |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 723 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 723 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.