| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | HEALTH NET | $85K | — | $85K | 4.83% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $44 | $15K | 10.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP A MARSH & MCLENNAN AGCY | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.32% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $209 | $3K | 6.95% |
| IMPACT BENEFIT MANAGEMENT SERVICES3 Filed as: IMPACT BENEFIT MANAGEMENT SVCS. INC | 3650 MANSELL ROAD, SUITE 100 ALPHARETTA, GA 30022 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $311 | — | $311 | 0.78% |
| ROBERT FRINK CROOM3 Filed as: ROBERT F. CROOM | 155 BRICKLEBERRY DRIVE ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $196 | — | $196 | 0.49% |
| GNW-EVERGREEN INSURANCE SERVICES3 | 16030 VENTURA BLVD., SUITE 500 ENCINO, CA 91416 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 0.21% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | SAFEGUARD HEALTH PLANS, INC. | $3K | — | $3K | 10.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP A MARSH & MCLENNAN AGCY | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC. | — | $386 | $386 | 1.30% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $580 | $580 | 2.14% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $524 | $3K | 15.34% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $383 | $383 | 2.00% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | EYEMED VISION CARE | $2K | — | $2K | 9.33% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 600 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $457 | $10 | $467 | 5.84% |
| ROBERT FRINK CROOM3 Filed as: ROBERT F. CROOM | 155 BRICKLEBERRY DRIVE ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $207 | — | $207 | 2.59% |
| GNW-EVERGREEN INSURANCE SERVICES3 | 16030 VENTURA BLVD., SUITE 500 ENCINO, CA 91416 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $89 | — | $89 | 1.11% |
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 | 214 | 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) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 217 | $1.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 361 | $168K |
| Vision | EYEMED VISION CARE | 354 | $18K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 214 | $87K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 135 | $40K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 69 | $19K |
| Prescription drug | HEALTH NET | 217 | $1.8M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.