| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR SUITE 320 SANTA ANA, CA 92704 | AETNA HEALTH, INC. | $49K | $11K | $60K | 5.60% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD SUITE 320 SANTA ANA, CA 92704 | AETNA HEALTH, INC. | — | $5K | $5K | 0.49% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD SUITE 320 SANTA ANA, CA 927047907 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 4.03% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD SUITE 320 SANTA ANA, CA 927047907 | UNITED CONCORDIA INSURANCE COMPANY | $8K | $225 | $8K | 10.24% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.45% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD SUITE 320 SANTA ANA, CA 927047907 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 8.15% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD SUITE 320 SANTA ANA, CA 927047907 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA INC | $2K | $65 | $2K | 10.36% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $783 | $2K | 15.36% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $977 | $551 | $2K | 15.63% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $775 | $434 | $1K | 15.59% |
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 | 335 | 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) | 336 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 20 | $121K |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 192 | $102K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 375 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $40K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $22K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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.