| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON STREET SUITE 1200 CONSHOHOCKEN, PA 19428 | ANTHEM BLUE CROSS | $17K | $1 | $17K | 0.69% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS | — | $14K | $14K | 0.58% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | ANTHEM BLUE CROSS | $12K | — | $12K | 0.47% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CALIFORN | 3605 GLENWOOD AVE SUITE 201 RALEIGH, NC 27612 | ANTHEM BLUE CROSS | — | $1 | $1 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | PO BOX 896620 CHARLOTTE, NC 282896620 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | — | $16K | 4.66% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 896620 CHARLOTTE, NC 282896620 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 4.55% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS., INC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 1.52% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 130 THEORY, STE. 200 IRVINE, CA 92617 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 3.87% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 18.76% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 19.78% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 15.51% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 19.95% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 896620 CHARLOTTE, NC 28289 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $540 | — | $540 | 2.17% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY, STE. 200 IRVINE, CA 92617 | DELTA DENTAL OF CALIFORNIA | $721 | — | $721 | 4.04% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $799 | $2K | 15.80% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | — |
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 | 342 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | ANTHEM BLUE CROSS | 308 | $3.1M |
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 350 | $123K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 282 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 348 | $46K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 53 | $48K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 349 | $28K |
| Prescription drug(4 contracts, 3 carriers) | ANTHEM BLUE CROSS | 308 | $3.1M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 348 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.