| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA PHYSICIANS SERVICE | $2K | $63K | $65K | 4.11% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W. HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | — | $33K | $33K | 2.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN INSURANCE AGENCY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | CALIFORNIA PHYSICIANS SERVICE | $652 | $19K | $19K | 1.23% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $4K | $6K | 3.96% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 3.82% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $830 | $2K | $3K | 7.88% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.59% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $750 | $750 | 2.18% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $701 | $1K | $2K | 7.77% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.50% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $750 | $750 | 2.68% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $418 | $907 | $1K | 7.76% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.55% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.31% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $608 | $876 | $1K | 9.01% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $744 | $744 | 4.52% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $330 | $748 | $1K | 8.01% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.54% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $948 | — | $948 | 7.87% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 85638 SAN DIEGO, CA 92186 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $258 | $630 | $888 | 7.37% |
| LONDONO MILLER BENEFITS INC4 Filed as: LONDONO MILLER BENEFITS INC. | 28326 ATLEY COURT SAUGUS, CA 91350 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $123 | — | $123 | 4.04% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $114 | — | $114 | 3.74% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $103 | — | $103 | 3.38% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $22 | — | $22 | 0.72% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 258 | $1.6M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $158K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 258 | $1.6M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $62K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 59 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $17K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 258 | $1.6M |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.