| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHUN-HA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BLVD. GARDEN GROVE, CA 92844 | COMPANION LIFE OF CALIFORNIA SAN FRANCISCO | $18K | — | $18K | 7.00% |
| CHUN-HA INSURANCE SERVICES, INC.3 | 9122 GARDEN GROVE BLVD. GARDEN GROVE, CA 92844 | SYMETRA LIFE INSURANCE COMPANY | $522 | $0 | $522 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS LIFE & HEALTH EIN 95-4331852 NETWORK PROVIDER | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $69K |
| E.B.A. & M CORPORATION EIN 95-2881702 TPA | Contract Administrator; Plan Administrator; Claims processing Service code 12 | — | $62K |
| CHUN-HA INSURANCE SERVICES, INC. EIN 20-8530155 BROKER | Insurance brokerage commissions and fees Service code 53 | — | $30K |
| CONSIDINE & ASSOCIATES EIN 35-7406633 CLAIMS REVIEW TPA | Claims processing Service code 12 | — | $5K |
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 | 205 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 205 | $10K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE OF CALIFORNIA SAN FRANCISCO | 316 | $252K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 205 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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.