| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, CA 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $11K | $0 | $11K | 9.33% |
| 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 | $6K | $0 | $6K | 5.00% |
| RALPH DANIEL PURINTON II3 Filed as: RALPH DANIEL PURINTON LL | PO BOX 3458 BLUE JAY, CA 92317 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 3.93% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | $0 | $2K | 37.56% |
| 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 | $204 | $0 | $204 | 5.02% |
| 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 | $75 | $0 | $75 | 7.98% |
| 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 | $35 | $0 | $35 | 8.03% |
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 | 258 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 363 | $1.5M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 244 | $98K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 111 | $121K |
| Other(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 2 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.