| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., SUITE 1200 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $29K | — | $29K | 4.10% |
| TAPERT INSURANCE AGENCY3 | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 9.99% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., SUITE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $231 | $2K | 16.79% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 10.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., SUITE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $113 | $1K | 16.40% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., SUITE 1200 WOODLAND HILLS, CA 91367 | CALIFORNIA DENTAL NETWORK, INC. | $752 | — | $752 | 10.50% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., SUITE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $248 | $26 | $274 | 16.57% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 104 | $706K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 74 | $52K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 107 | $11K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $8K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 104 | $706K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.