| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W. 5TH ST. OXNARD, CA 93030 | BLUE CROSS OF CALIFORNIA | $18K | — | $18K | 4.16% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $8K | $20K | 17.74% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $808 | $6K | 5.38% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $4K | 3.33% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE #112 TORRENCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $639 | $3K | 2.23% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $338 | $2K | 1.78% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $433 | $2K | 1.73% |
| GENE BISSINGER3 | 4077 SNOWGOOSE ST SIMI VALLEY, CA 93065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $25 | $1K | 1.12% |
| DOUGLAS LOYAL NERDAHL3 | 41 W 4TH AVE SAM MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $932 | $4 | $936 | 0.82% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $692 | $164 | $856 | 0.75% |
| VINCENT GERARD MCLAUGHLIN3 | 4739 MASCAGNI STREET VENTURA, CA 93003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $601 | $126 | $727 | 0.64% |
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W FIFTH ST OXNARD, CA 93030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $515 | $0 | $515 | 0.45% |
| RICHARD C SUTHERLAND III3 | 3601 FIGUEROA ST GLENDALE, CA 91206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $293 | $118 | $411 | 0.36% |
| GIOVANNA HUGHES3 | PO BOX 1161 STUDIO CITY, CA 91614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $340 | $23 | $363 | 0.32% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | $126 | $359 | 0.32% |
| MARJORIE ANN MARQUARDT3 | 1681 VERANADA AVE ALTADENA, CA 91001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $336 | $0 | $336 | 0.30% |
| JAKORP INC3 | 14458 CRESTWOOD AVENUE POWAY, CA 92064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $126 | $253 | 0.22% |
| FERNAN ENRIQUE LOPEZ3 | 735 DOLORES ST #1 SAN FRANCISCO, CA 94110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | $90 | $230 | 0.20% |
| PHYLLIS ILENE SHALLMAN3 | 1121 UNIVERSITY BLVD W SILVER SPRING, MD 20902 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $196 | $27 | $223 | 0.20% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $66 | $193 | 0.17% |
| BARRY W MAAS3 | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $67 | $157 | 0.14% |
| MERRICK D. SWENSON3 Filed as: MERRICK D SWENSON | 11104 S GARDNER ROAD CHENEY, WA 99004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 0.05% |
| ALAN ROSENBERGER3 | 13 PHAROAHS RUN RD RIVESVILLE, WV 26588 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.04% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE ST LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.04% |
| YOLO ENTERPRISE INC3 | 5403 HERON BAY LONG BEACH, CA 90803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $16 | $42 | 0.04% |
| KEVIN FITZGERALD HOWARD3 | 3902 HATHAWAY AVE LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $11 | $37 | 0.03% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 0.03% |
| KYM ELIZABETH DUNHAM3 | 828 SAFFLOWER CT HENDERSON, NV 89015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.03% |
| CONRAD R SUECHTING3 | 27362 POTATO FARM ROAD ONTONAGON, MI 49953 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.02% |
| ELIZABETH J DOWNEY3 | 6113 N CUMBERLAND RD MUNCIE, IN 47304 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.02% |
| PAUL WAYNE GUILLOT3 | 8829 SHIRLEY-FRANCIS SHREVEPORT, LA 71129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.01% |
| GREYHAVENS CONSULTING LLC3 | 1313 E MAPLE STREET BELLINGHAM, WA 98225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| SADIE BLACKMON3 | 627 RAPIDS RD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| GINA M WESOLEK3 | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| GREG HOPE3 | 111 CHESTNUT ST WESTON, WV 26452 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| TONI JACKSON3 | 17341 BIRCHCREST DETROIT, MI 48221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| PATRICIA REED3 | 569 THORNHILL COURT BELLEVILLE, MI 48111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| FLORENCE RYDEN3 | 2950 BENT TREE HILLS DR NEW BRIGHTON, MN 55112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| DEBORAH ALEXAKOS3 | 5475 N MITCHUM AVE MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| DAVID M RYDEN3 | 2950 BENT TREE HILLS DR NEW BRIGHTON, MN 55112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| STEVE BUFFONE3 | C/O BUFFONE AND ASSOCIATES LAS VEGAS, NV 89123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| CATHY BUFFONE3 | C/O BUFFONE AND ASSOCIATES LAS VEGAS, NV 89123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| BSK BENEFITS PLUS LLC3 | 205 PINECREST DR. COVINGTON, LA 70433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| HELEN RODRIGUEZ-BURTON3 | PO BOX 10021 AMARILLO, TX 79116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 32101 FALL RIVER ROAD TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W. 5TH ST. OXNARD, CA 93030 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $261 | — | $261 | 4.15% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | THE PAUL REVERE LIFE INSURANCE COMPANY | $768 | $188 | $956 | 24.39% |
| DOUGLAS LOYAL NERDAHL3 | 41 W 4TH AVE SAM MATEO, CA 94402 | THE PAUL REVERE LIFE INSURANCE COMPANY | $402 | $2 | $404 | 10.31% |
| DAVID WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | THE PAUL REVERE LIFE INSURANCE COMPANY | $114 | $15 | $129 | 3.29% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | THE PAUL REVERE LIFE INSURANCE COMPANY | $104 | $0 | $104 | 2.65% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | THE PAUL REVERE LIFE INSURANCE COMPANY | $35 | $5 | $40 | 1.02% |
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W FIFTH ST OXNARD, CA 93030 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.10% |
| JAKORP INC3 | 14458 CRESTWOOD AVENUE POWAY, CA 92064 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.08% |
| INSGROUP INC3 Filed as: THE INSURANCE GROUP DBA BARKLE | 143 W. 5TH ST. OXNARD, CA 93030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $397 | — | $397 | 32.92% |
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 | 289 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS OF CALIFORNIA | 107 | $427K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 77 | $6K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 289 | $119K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 207 | $117K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 107 | $427K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 289 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.