| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | $0 | $7K | 7.63% |
| B&G PENSION AND INSURANCE SERVICES Filed as: B & G PENSION AND INS SVCS INC | 18010 SKY PARK CIR #108 IRVINE, CA 92614 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | $0 | $5K | 5.00% |
| RALPH DANIEL PURINTON II | PO BOX 3458 BLUE JAY, CA 92317 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 4.69% |
| B&G PENSION AND INSURANCE SERVICES Filed as: B & G PENSION AND SVCS INC | 18010 SKY PARK CIR #108 IRVINE, CA 92614 | AMERICAN FIDELITY ASSURANCE COMPANY | $994 | $0 | $994 | 7.99% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$169 | $0 | -$169 | -1.36% |
| B&G PENSION AND INSURANCE SERVICES Filed as: B & G PENSION AND SVCS INC | 18010 SKY PARK CIR #108 IRVINE, CA 92614 | AMERICAN FIDELITY ASSURANCE COMPANY | $487 | $0 | $487 | 8.00% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $232 | $0 | $232 | 7.08% |
| B&G PENSION AND INSURANCE SERVICES Filed as: B & G PENSION AND INS SVCS INC | 18010 SKY PARK CIR #108 IRVINE, CA 92614 | AMERICAN FIDELITY ASSURANCE COMPANY | $165 | $0 | $165 | 5.03% |
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 | 228 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 214 | $81K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 90 | $91K |
| Other(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 42 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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.