| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $63K | — | $63K | 7.04% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 2.38% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 23.11% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.12% |
| D ERRICO, NICHOLAS, RYAN3 | 3322 RUTH ELAINE DR LOS ALAMITOS, CA 90720 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $149 | — | $149 | 0.75% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 8.84% |
| D ERRICO, NICHOLAS, RYAN3 | 3322 RUTH ELAINE DR LOS ALAMITOS, CA 90720 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $64 | — | $64 | 0.51% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 23.08% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 21.41% |
| JACOB ZARAYA3 | PO BOX 6712 WOODLAND HILLS, CA 91365 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 20.60% |
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 | 155 | 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) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 243 | $957K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 243 | $895K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 243 | $895K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 102 | $56K |
| Short-term disability(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 34 | $24K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 11 | $7K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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.