| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INSURANCE, INC. | 3130 WILSHIRE BLVD., SUITE 200 SANTA MONICA, CA 90403 | UNITED HEALTHCARE INSURANCE COMPANY | $27K | — | $27K | 4.15% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INSURANCE, INC. | 3130 WILSHIRE BLVD., SUITE 200 SANTA MONICA, CA 90403 | UNITED CONCORDIA INSURANCE COMPANY | $2K | — | $2K | 9.36% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INSURANCE, INC. | 3130 WILSHIRE BLVD., SUITE 200 SANTA MONICA, CA 90403 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| MJ INSURANCE3 Filed as: WHITE & COMPANY INSUANCE | 3130 WILSHIRE BLVD., SUITE 200 SANTA MONICA, CA 90403 | EYEMED VISION CARE | $548 | — | $548 | 9.96% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE & COMPANY INSURANCE, INC. | 3130 WILSHIRE BLVD., SUITE 200 SANTA MONICA, CA 90403 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $125 | — | $125 | 9.98% |
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 | 190 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 87 | $642K |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 41 | $31K |
| Vision | EYEMED VISION CARE | 115 | $6K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 190 | $12K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 87 | $642K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 190 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.