| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE | $14K | $0 | $14K | 7.97% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $5K | $0 | $5K | 8.00% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVENUE SUITE 325 WOODLAND HILLS, CA 91367 | SYMETRA LIFE INSURANCE | $9K | $0 | $9K | 15.01% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVENUE #325 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE | $2K | $0 | $2K | 10.11% |
| JOHNSON RESOURCES3 | 7373 E DOUBLETREE RANCH #200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE | $401 | $0 | $401 | 2.01% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVENUE 325 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $809 | $0 | $809 | 4.48% |
| MICHAEL STUART3 | 28494 WESTINGHOUSE PL VALENCIA, CA 91355 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $105 | $0 | $105 | 0.58% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVENUE SUITE 325 WOODLAND HILLS, CA 91367 | UNUM | $1K | $0 | $1K | 8.30% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF NEW JERSEY, INC. | $485 | $0 | $485 | 8.01% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF COLORADO | $55 | $0 | $55 | 7.99% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH PLAN OF ARIZONA | $44 | $0 | $44 | 7.99% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF NORTH CAROLINA | $22 | $0 | $22 | 8.00% |
| MICHAEL STUART3 | 28494 WESTINGHOUSE PL VALENCIA, CA 91355 | FIRST UNUM LIFE INSURANCE CO | $3 | $0 | $3 | 1.99% |
| PETER C. FOY & ASSOCIATES3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| POMCO WEST, INC. EIN 46-2975338 NONE | Claims processing Service code 12 | — | $103K |
| ANTHEM BLUE CROSS LIFE & HEALTH EIN 95-4331852 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing; Other services Service code 12 | — | $101K |
| POMCOPLUS, LLC EIN 45-0482796 NONE | Claims processing Service code 12 | — | $10K |
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. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. | 0 | $0 |
| Dental(6 contracts, 6 carriers) | CIGNA HEALTH AND LIFE INSURANCE | 264 | $252K |
| Vision | EYEMED VISION CARE | 525 | $20K |
| Life insurance | SYMETRA LIFE INSURANCE | 330 | $62K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH FINANCIAL SERVICES | 295 | $334K |
| Other(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE | 330 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 525 | — |
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.