| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P O BOX 25360 OKLAHOMA, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $10K | $0 | $10K | 6.75% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 923173458 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | $0 | $7K | 4.57% |
| BIGGERSTAFF INSURANCE SERVICES INC Filed as: BIGGERSTAFF INSURANCE SERVICES, INC | P O BOX 10968 NEWPORT BEACH, CA 92658 | AMERICAN FIDELITY ASSURANCE COMPANY | $558 | $0 | $558 | 0.39% |
| BIG INSURANCE SERVICES INC. Filed as: BIG INSURANCE SERVICES, INC | P O BOX 10968 NEWPORT BEACH, CA 92658 | AMERICAN FIDELITY ASSURANCE COMPANY | $51 | $0 | $51 | 0.04% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 923173458 | UNITED HEALTHCARE | $4K | $0 | $4K | 3.72% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 923173458 | AMERICAN FIDELITY ASSURANCE COMPANY | $482 | $0 | $482 | 4.87% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P O BOX 2536 OKLAHOMA CITY, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $401 | $0 | $401 | 4.05% |
| BIGGERSTAFF INSURANCE SERVICES INC Filed as: BIGGERSTAFF INSURANCE SERVICES, INC | P O BOX 10968 NEWPORT BEACH, CA 92658 | AMERICAN FIDELITY ASSURANCE COMPANY | $12 | $0 | $12 | 0.12% |
| BIG INSURANCE SERVICES INC. Filed as: BIG INSURANCE SERVICES, INC | P O BOX 10968 NEWPORT BEACH, CA 92658 | AMERICAN FIDELITY ASSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P O BOX 25360 OKLAHOMA CITY, OK 761250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $96 | $0 | $96 | 26.67% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 923173458 | AMERICAN FIDELITY ASSURANCE COMPANY | $18 | $0 | $18 | 5.00% |
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 | 316 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER PERMANENTE | 361 | $1.7M |
| Dental | UNITED HEALTHCARE | 251 | $111K |
| Life insurance | AMERICAN FIDELITY ASSURANCE COMPANY | 0 | $360 |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 147 | $142K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 4 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.