| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 2400 KATELLA AVENUE SUITE 1100 ANAHEIM, CA 92806 | CALIFORNIA PHYSICIANS' SERVICE | $74K | — | $74K | 5.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 2400 E KATELLA AVENUE SUITE 1100 ANAHEIM, CA 928065980 | PRINCIPAL LIFE INSURANCE COMPANY | $26K | — | $26K | 8.64% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICE INC | 1600 W HILLSDALE BLVD ATTN VIVIAN LEUS SAN MATEO, CA 944023768 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 3.00% |
| BB&T BARGER INSURANCE NETWORK3 | 414 GALLIMORE DAIRY RD, STE F ATTN COMMISSIONS MANAGER GREESBORO, NC 274099693 | PRINCIPAL LIFE INSURANCE COMPANY | — | $3K | $3K | 1.10% |
| ERNEST MONTEZ CHAVEZ3 | 16130 VENTURA BLVD STE 210 ENCINO, CA 914362526 | PRINCIPAL LIFE INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 2400 KATELLA AVENUE STE 1100 ANAHEIM, CA 92806 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $2K | — | $2K | 9.89% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $357 | — | $357 | 1.96% |
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 | 227 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 218 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 517 | $299K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 517 | $299K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 517 | $317K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 218 | $1.5M |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 227 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 517 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.