| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED HEALTHCARE INSURANCE COMPANY | $109K | — | $109K | 5.58% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | — | $30K | 5.60% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | — | $13K | 3.96% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $16K | — | $16K | 5.82% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | VISION SERVICE PLAN | $5K | — | $5K | 7.69% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 9.20% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 8.87% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 9.19% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $846 | $709 | $2K | 9.19% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $697 | $562 | $1K | 9.04% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $479 | $401 | $880 | 9.19% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METLIFE LEGAL PLANS | $655 | $87 | $742 | 11.69% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | MUTUAL OF OMAHA INSURANCE COMPANY | $303 | $242 | $545 | 8.98% |
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 | 1,015 | 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) | 1,015 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 432 | $2.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 447 | $322K |
| Vision | VISION SERVICE PLAN | 313 | $60K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,015 | $81K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 94 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $17K |
| Prescription drug(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 432 | $2.8M |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,015 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,015 | — |
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.