| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P O BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $18K | — | $18K | 12.74% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 92317 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 4.70% |
| BIGGERSTAFF INSURANCE SERVICES INC | P O BOX 10968 NEWPORT BEACH, CA 92658 | AMERICAN FIDELITY ASSURANCE COMPANY | $421 | — | $421 | 0.30% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 92317 | UNITED HEALTH CARE INSURANCE COMPANY | $4K | — | $4K | 4.08% |
| RALPH DANIEL PURINTON II | P O BOX 3458 BLUE JAY, CA 92317 | AMERICAN FIDELITY ASSURANCE COMPANY | $459 | — | $459 | 4.86% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P O BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $354 | — | $354 | 3.75% |
| BIGGERSTAFF INSURANCE SERVICES INC | P O BOX 10968 NEWPORT BEACH, CA 92658 | AMERICAN FIDELITY ASSURANCE COMPANY | $14 | — | $14 | 0.15% |
| RALPH DANIEL PURINTON II | PO BOX 3458 BLUE JAY, CA 92504 | AMERICAN FIDELITY ASSURANCE COMPANY | $38 | — | $38 | 5.03% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P O BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $17 | — | $17 | 2.25% |
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 | 249 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 301 | $1.7M |
| Dental | UNITED HEALTH CARE INSURANCE COMPANY | 199 | $96K |
| Life insurance | AMERICAN FIDELITY ASSURANCE COMPANY | 0 | $756 |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 112 | $139K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 5 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.