| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R L SELLERS INSURANCE SERVICES INC3 | PO BOX 17011 ANAHEIM HILLS, CA 92817 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $66K | — | $66K | 5.00% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $28K | $28K | 2.15% |
| LESLIE DAVIES3 | 19 MERITAGE COTO DE CAZA, CA 92679 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 3.51% |
| WALTER LEVY3 | RTHO PO BOX 711 C5 PORTLAND, OR 97207 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 2.93% |
| R L SELLERS INSURANCE SERVICES INC3 Filed as: R L SELLERS INSURANCE SERVICES, | INC. PO BOX 17011 ANAHEIM, CA 928177011 | VISION SERVICE PLAN | $1K | — | $1K | 5.08% |
| LESLIE DAVIES3 | 19 MERITAGE COTO DE CAZA, CA 92679 | STANDARD INSURANCE COMPANY | $709 | — | $709 | 4.63% |
| WALTER LEVY3 | RTHO PO BOX 711 C5 PORTLAND, OR 97207 | STANDARD INSURANCE COMPANY | $486 | — | $486 | 3.17% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 156 | $1.3M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 156 | $1.3M |
| Vision | VISION SERVICE PLAN | 104 | $24K |
| Life insurance | STANDARD INSURANCE COMPANY | 148 | $15K |
| Long-term disability | STANDARD INSURANCE COMPANY | 148 | $66K |
| Other | STANDARD INSURANCE COMPANY | 148 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.
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.