| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R L SELLERS INSURANCE SERVICES INC3 Filed as: R.L. SELLERS INSURANCE SERVICES INC | P O BOX 17011 ANAHEIM, CA 92817 | AETNA HEALTH OF CALIFORNIA, INC. | $24K | — | $24K | 4.60% |
| AMWINS3 Filed as: LEBHERZ INSURANCE SERVICES INC LISI | 1600 WEST HILLSDALE BLVD SAN MATEO, CA 94402 | AETNA HEALTH OF CALIFORNIA, INC. | $5K | — | $5K | 0.92% |
| R L SELLERS INSURANCE SERVICES INC3 Filed as: R.L. SELLERS INSURANCE INC | P O BOX 17011 ANAHEIM, CA 92817 | AETNA LIFE INSURANCE CO. | $14K | — | $14K | 4.57% |
| AMWINS3 Filed as: LEBHERZ INSURANCE SERVICES INC LISI | 1600 WEST HILLSDALE BLVD SAN MATEO, CA 94402 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 0.91% |
| R L SELLERS INSURANCE SERVICES INC3 | P O BOX 17011 ANAHEIM, CA 928177011 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 4.86% |
| WALTER L LEVY3 | 4028 SEBREN AVE LAKEWOOD, CA 90713 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 4.15% |
| LESLIE DAVIES3 | 19 MERITAGE COTO DE CAZA, CA 92679 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 4.15% |
| R L SELLERS INSURANCE SERVICES INC3 Filed as: R L SELLERS INSURANCE SERVICES,INC. | P O BOX 17011 ANAHEIM, CA 928177011 | VISION SERVICE PLAN | $1K | — | $1K | 5.02% |
| WALTER L LEVY3 | 4028 SEBREN AVE LAKEWOOD, CA 90713 | STANDARD INSURANCE COMPANY | $740 | — | $740 | 4.53% |
| LESLIE DAVIES3 | 19 MERITAGE COTO DE CAZA, CA 92679 | STANDARD INSURANCE COMPANY | $740 | — | $740 | 4.53% |
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 | 149 | 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) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 51 | $304K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 136 | $74K |
| Vision | VISION SERVICE PLAN | 101 | $25K |
| Life insurance | STANDARD INSURANCE COMPANY | 149 | $16K |
| Long-term disability | STANDARD INSURANCE COMPANY | 149 | $55K |
| Other | STANDARD INSURANCE COMPANY | 149 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.