| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| S3M INSURANCE SERVICES LLC3 | 183 MONTE VISTA, UNIT A COSTA MESA, CA 92627 | ANTHEM BLUE CROSS | $50K | — | $50K | 6.47% |
| S3M INSURANCE SERVICES LLC3 | 183 MONTE VISTA, UNIT A COSTA MESA, CA 92627 | KAISER FOUNDATION HEALTH PLAN, INC. | $21K | — | $21K | 4.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN, INC | 721 S PARKER ST, STE 300 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 0.53% |
| SNA CORPORATION3 | 2780 SKYPARK DR. #440 TORRANCE, CA 90505 | HEALTH NET | $9K | — | $9K | 2.95% |
| S3M INSURANCE SERVICES LLC3 | 183 MONTE VISTA, UNIT A COSTA MESA, CA 92627 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 6.59% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | — | $8K | $8K | 5.59% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | PRINCIPAL LIFE INSURANCE COMPANY | $677 | — | $677 | 0.47% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN BENEFIT ADMIN | 721 S PARKER ST, STE 300 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | — | $590 | $590 | 0.41% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS | 87 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 121 | $145K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 121 | $145K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 121 | $145K |
| Prescription drug(3 contracts, 3 carriers) | ANTHEM BLUE CROSS | 87 | $1.5M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 121 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.