| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | 750 B STREET SUITE 2400 SAN DIEGO, CA 92101 | MEDIEXCEL HEALTH PLAN | $7K | — | $7K | 4.61% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN INSURANCE AGENCY | PO BOX 85638 SAN DIEGO, CA 921865638 | MEDIEXCEL HEALTH PLAN | $605 | — | $605 | 0.40% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B STREET SUITE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 9.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MVI ADMINISTRATORS INSURANCE EIN 33-0393692 PLAN MANAGEMENT | Plan Administrator Service code 14 | 2615 CAMINO DEL RIO SOUTH SUITE 201 SAN DIEGO, CA 92108 | $182K |
| HEALTHCOMP LLC EIN 77-0385729 CLAIMS PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 45018 FRESNO, CA 93721 | $115K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 CLAIMS PROCESSING | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Claims processing Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $48K |
| MCGRIFF INSURANCE SERVICES INC EIN 56-1623293 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 720 B STREET SAN DIEGO, CA 92101 | $45K |
| BEESON, HOFFMAN & SIDDALL INC EIN 95-3654092 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 500 NORTH CENTRAL AVENUE SUITE 325 GLENDALE, CA 91203 | $21K |
| SHEPPARD MULLIN RICHTER & HAMPTON EIN 95-1463164 ATTORNEY | Legal Service code 29 | 12275 EL CAMINO REAL SAN DIEGO, CA 92130 | $12K |
| ANTHEM BLUE CROSS LIFE AND HEALTH 9 | Other commissions; Insurance agents and brokers; Non-monetary compensation Service code 22 | — | $0 |
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 | 193 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 0 | $0 |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $11K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 183 | $570K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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."
No prospect flags tripped on this filing.