| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHUN-HA INSURANCE SERVICES, INC.3 | 12912 BROOKHURST ST STE 480 GARDEN GROVE, CA 92840 | PAN AMERICAN LIFE INSURANCE | $15K | — | $15K | 7.00% |
| CHUN-HA INSURANCE SERVICES, INC.3 | 12912 BROOKHURST ST STE 480 GARDEN GROVE, CA 92840 | SYMETRA LIFE INSURANCE COMPANY | $380 | — | $380 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS LIFE & HEALTH EIN 95-4331852 NETWORK PROVIDER | Float revenue; Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $62K |
| E.B.A. & M. CORPORATION EIN 95-2881702 TPA | Plan Administrator; Contract Administrator; Claims processing Service code 12 | — | $61K |
| CHUN-HA INSURANCE SERVICES, INC. EIN 20-8530155 BROKER | Insurance brokerage commissions and fees Service code 53 | — | $30K |
| CONSIDINE & ASSOCIATES EIN 35-7406633 AUDITOR | Accounting (including auditing) Service code 10 | — | $7K |
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 | 213 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 219 | $8K |
| Stop-loss / reinsurancereinsurance | PAN AMERICAN LIFE INSURANCE | 471 | $219K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 219 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.