| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 926123065 | BLUE SHIELD OF CALIFORNIA | $80K | — | $80K | 5.00% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $15K | $23 | $15K | 3.81% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES, INC. | 130 THEORY STREET, SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $15K | $22 | $15K | 4.06% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY, SUITE 200 IRVINE, CA 926173065 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 4.00% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $628 | $6K | 11.25% |
| FBP INSURANCE SERVICES3 | 130 THEORY, STE 200 IRVINE, CA 926173065 | VISION SERVICE PLAN | $3K | — | $3K | 7.50% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $202 | $2K | 5.56% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $42 | $3K | 16.25% |
| PROVIEW ADVANCED SOLUTIONS3 | 130 THEORY, STE 200 IRVINE, CA 92617 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $934 | $934 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 E FOOTHILL BL., #100 PASADENA, CA 91107 | FEDERAL INSURANCE COMPANY | $607 | — | $607 | 15.01% |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 180 | $2.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 306 | $234K |
| Vision | VISION SERVICE PLAN | 161 | $34K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $51K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 162 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 162 | $50K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 180 | $1.6M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 162 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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."
No prospect flags tripped on this filing.