| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCJF INSURANCE SERVICES INC3 | 1725 S DOUGLASS RD. SUITE D ANAHEIM, CA 92806 | AETNA LIFE INSURANCE CO. | $650 | — | $650 | 9.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general) Service code 16 | — | $35K |
| SHAH & ASSOCIATES EIN 26-4391858 NONE | Legal Service code 29 | — | $21K |
| SO CAL PIPE TRADES ADMIN CORP. EIN 95-4557526 NONE | Contract Administrator Service code 13 | — | $13K |
| LINQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| US BANK EIN 31-0841368 NONE | Custodial (securities) Service code 19 | — | $10K |
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 | 338 | 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) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL HEALTH SERVICES | 52 | $9K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 190 | $8K |
| Life insurance | AETNA LIFE INSURANCE CO. | 338 | $7K |
| Other | AETNA LIFE INSURANCE CO. | 338 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.