| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | UNITEDHEALTHCARE INSURANCE COMPANY | $45K | $0 | $45K | 2.57% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | UNITEDHEALTHCARE INSURANCE COMPANY | $29K | $0 | $29K | 1.69% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $9K | 8.08% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.23% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $226 | $1K | 9.52% |
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 | 234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 307 | $1.7M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 307 | $1.7M |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 262 | $15K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 211 | $118K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 211 | $118K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 211 | $118K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 307 | $1.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 211 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 307 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.