| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $120K | — | $120K | 7.81% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $23K | $1K | $24K | 21.92% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $3K | $10K | 15.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 7.81% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 15.00% |
| CONTINENTAL - SEE ATTACHMENT3 Filed as: CONTINENTAL AM - SEE ATTACHMENT | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 30.24% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | ANTHEM LIFE INSURANCE COMPANY | $949 | — | $949 | 7.82% |
| LISA N PEART4 | 1426 W 121ST STREET LOS ANGELES, CA 90047 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $150 | — | $150 | 2.98% |
| JOHN PACHECO4 | 3436 E SYCAMORE AVENUE VISALIA, CA 93292 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $139 | — | $139 | 2.76% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $119 | — | $119 | 2.37% |
| INTEGRETITY ASSET SERVICES LLC4 | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $74 | — | $74 | 1.47% |
| NICOLE BUTKOVICH4 | 199 MIRIAM WAY CARSON CITY, NV 89706 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $35 | — | $35 | 0.70% |
| ANGEL L. STEPHENS4 | PO BOX 36114 LOS ANGELES, CA 90036 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $17 | — | $17 | 0.34% |
| ALLIANT INSURANCE SERVICES, INC.3 | 333 SOUTH HOPE STREET, SUITE 3750 LOS ANGELES, CA 90071 | EYEMED VISION CARE | $437 | — | $437 | 19.89% |
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 | 500 | 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) | 500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 276 | $1.6M |
| Dental | BLUE CROSS OF CALIFORNIA | 276 | $1.5M |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 436 | $50K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $143K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $78K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 276 | $1.5M |
| Other(6 contracts, 5 carriers) | AFLAC | 490 | $278K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.