| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARROYO INSURANCE SERVICES, INC.3 | PO BOX 661840 ARCADIA, CA 91066 | AETNA HEALTH OF CALIFORNIA INC. | $100K | $0 | $100K | 4.57% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 204 SHERMAN OAKS, CA 91423 | KAISER FOUNDATION HEALTH PLAN INC | $47K | $0 | $47K | 5.00% |
| ARROYO INSURANCE SERVICES, INC.3 | PO BOX 661840 ARCADIA, CA 91066 | AETNA LIFE INSURANCE COMPANY | $33K | $0 | $33K | 4.94% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 304 SHERMAN OAKS, CA 91423 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.41% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 204 SHERMAN OAKS, CA 91413 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 8.16% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 204 SHERMAN OAKS, CA 91413 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 15.00% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 204 SHERMAN OAKS, CA 91423 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $0 | $2K | 7.09% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 204 SHERMAN OAKS, CA 91413 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $171 | $0 | $171 | 2.54% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE, SUITE 204 SHERMAN OAKS, CA 91413 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $596 | $0 | $596 | 20.01% |
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 | 401 | 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) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 429 | $3.8M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 579 | $401K |
| Vision | VISION SERVICE PLAN | 404 | $58K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $84K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $43K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 429 | $3.8M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 579 | — |
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.