| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS OF CA, INC. | 02 PARK PLAZA, SUITE 440 IRVINE, CA 92614 | BLUE CROSS OF CALIFORNIA | $43K | $0 | $43K | 4.51% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: LIBERTY COMPANY INSURANCE BRKS LLC | 5955 DE SOTO AVENUE SUITE 250 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $4K | $0 | $4K | 0.43% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS OF VA, INC. | 11220 ASSET LOOP, SUITE 104 MANASSAS, VA 20109 | BLUE CROSS OF CALIFORNIA | $0 | $799 | $799 | 0.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS OF CA, INC. | 1001 MARK AVENUE, SUITE 201 CARPINTERIA, CA 93013 | VISION SERVICE PLAN | $278 | $0 | $278 | 1.95% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $238 | $0 | $238 | 1.67% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS. CENTER | 1001 MARK AVENUE, SUITE 201 CARPINTERIA, CA 93013 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $787 | $0 | $787 | 17.80% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 199 | $962K |
| Dental | BLUE CROSS OF CALIFORNIA | 199 | $962K |
| Vision | VISION SERVICE PLAN | 97 | $14K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $4K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 199 | $962K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.