| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $151K | — | $151K | 4.99% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $27 | $21K | 5.98% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 1018 W 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.96% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $9K | $0 | $9K | 5.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 150 N MICHIGAN AVENUE STE 3900 CHICAGO, IL 60601 | HARTFORD LIFE AND ACCIDENT | $0 | $4K | $4K | 2.05% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.94% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.71% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, INC | $127 | — | $127 | 5.65% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC | — | $42 | $42 | 1.87% |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 212 | $3.0M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 673 | $388K |
| Vision(2 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 208 | $62K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 213 | $3.2M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 213 | $183K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 213 | $183K |
| Prescription drug | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 2 | $33K |
| Other | HARTFORD LIFE AND ACCIDENT | 213 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 673 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.