| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | UNITED HEALTHCARE INSURANCE COMPANY | $84K | — | $84K | 6.02% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | KAISER FOUNDATION HEALTH PLAN INC. | $27K | — | $27K | 4.69% |
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 4.86% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 4.43% |
| DAWN D SHEUE3 Filed as: DAWN D. SHEUE | P.O. BOX 3986 JACKSON, WY 83001 | 5STAR LIFE INSURANCE COMPANY | $479 | — | $479 | 1.36% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 16.00% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 16.00% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 16.00% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | SAFEGUARD HEALTH PLANS, INC. | $2K | — | $2K | 9.79% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | SAFEGUARD HEALTH PLANS, INC. | $1K | — | $1K | 4.89% |
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 | 232 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 213 | $2.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 504 | $176K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 504 | $154K |
| Life insurance(3 contracts, 2 carriers) | 5STAR LIFE INSURANCE COMPANY | 232 | $94K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 91 | $26K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 141 | $25K |
| Prescription drug(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 213 | $2.2M |
| Other(2 contracts, 2 carriers) | 5STAR LIFE INSURANCE COMPANY | 232 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.