| 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 | $6K | $0 | $6K | 4.42% |
| PURINTON II, RALPH DANIEL | PO BOX 3458 BLUE JAY, CA 92317 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | $0 | $6K | 4.30% |
| BIG INSURANCE SERVICES INC. Filed as: BIG INSURANCE SERVICES INS | 18010 SKY PARK CIR #100 IRVINE, CA 92614 | AMERICAN FIDELITY ASSURANCE COMPANY | $964 | $0 | $964 | 0.71% |
| RALPH DANIEL PURINTON II3 | PO BOX 3458 BLUE JAY, CA 92317 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 3.96% |
| PURINTON II, RALPH DANIEL | PO BOX 3458 BLUE JAY, CA 92317 | AMERICAN FIDELITY ASSURANCE COMPANY | $575 | $0 | $575 | 4.72% |
| BIG INSURANCE SERVICES INC. Filed as: BIG INSURANCE SERVICES INC | 18010 SKY PARK CIR #100 IRVINE, CA 92614 | AMERICAN FIDELITY ASSURANCE COMPANY | $25 | $0 | $25 | 0.21% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$175 | $0 | -$175 | -1.44% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $51 | $0 | $51 | 35.42% |
| PURINTON II, RALPH DANIEL | PO BOX 3458 BLUE JAY, CA 92317 | AMERICAN FIDELITY ASSURANCE COMPANY | $7 | $0 | $7 | 4.86% |
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 | 259 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 348 | $1.7M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 233 | $100K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 0 | $144 |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 136 | $135K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 5 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.