| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W. FIFTH STREET OXNARD, CA 93030 | BLUE CROSS OF CALIFORNIA | $24K | — | $24K | 4.74% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $7K | $14K | 11.80% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $518 | $2K | 1.56% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $283 | $2K | 1.49% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE #112 TORRENCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $159 | $1K | 1.23% |
| DAVID WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $9 | $1K | 1.07% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $428 | $0 | $428 | 0.37% |
| GENE BISSINGER3 | 4077 SNOWGOOSE ST SIMI VALLEY, CA 93065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $360 | $0 | $360 | 0.31% |
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W FIFTH ST OXNARD, CA 93030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275 | $28 | $303 | 0.26% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $247 | $10 | $257 | 0.22% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $200 | $29 | $229 | 0.20% |
| VINCENT GERARD MCLAUGHLIN3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $118 | $42 | $160 | 0.14% |
| JAKORP INC3 | 15254 WINESPRINGS CT SAN DIEGO, CA 92127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $65 | $159 | 0.14% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $52 | $146 | 0.13% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $115 | $4 | $119 | 0.10% |
| DOUGLAS LOYAL NERDAHL3 | 41 W 4TH AVE SAM MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $8 | $96 | 0.08% |
| GIOVANNA HUGHES3 | PO BOX 1161 STUDIO CITY, CA 91614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $14 | $91 | 0.08% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE MARIE STUEMKY | 10208 MIDDLE DARLEEN LEANDER, TX 78641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $3 | $78 | 0.07% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $59 | $77 | 0.07% |
| BARBARA J LAKE3 | 226 N HIGH ST MORRISTOWN, IN 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $5 | $76 | 0.07% |
| PHYLLIS ILENE SHALLMAN3 | 1121 UNIVERSITY BLVD W SILVER SPRING, MD 20902 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 0.07% |
| JAMES M EANES3 | 1700 E JACKSON ST PENSACOLA, FL 32501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $10 | $68 | 0.06% |
| ALAN ROSENBERGER3 | 13 PHAROAHS RUN RD RIVESVILLE, WV 26588 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | $0 | $47 | 0.04% |
| RICHARD C SUTHERLAND III3 | 3601 FIGUEROA ST GLENDALE, CA 91206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.04% |
| MERRICK D. SWENSON3 Filed as: MERRICK D SWENSON | 11104 S GARDNER ROAD CHENEY, WA 99004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | $0 | $43 | 0.04% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE ST LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.04% |
| THOMAS & FARR AGENCY INC3 Filed as: THOMAS AND FARR AGENCY INC | 2200 TOWER DRIVE MONROE, LA 71201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 0.03% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.03% |
| KYM ELIZABETH DUNHAM3 | 828 SAFFLOWER CT HENDERSON, NV 89015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.03% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $6 | $26 | 0.02% |
| CARL L REED3 | 11727 TIMBER RIDGE DRIVE KEITHVILLE, LA 71047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.02% |
| SARA SORENSEN-CONNICK3 | 8547 E ARAPAHOE GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $11 | $22 | 0.02% |
| STALTARE BENEFITS INC3 | 700 E ATLANTIC BLVD POMPANO BEACH, FL 33060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $11 | $20 | 0.02% |
| FERNAN ENRIQUE LOPEZ3 | 735 DOLORES ST #1 SAN FRANCISCO, CA 94110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $4 | $17 | 0.01% |
| ELIZABETH J DOWNEY3 | 2883 OAKWOOD DR PORT HURON, MI 48060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.01% |
| CONRAD R SUECHTING3 | 27362 POTATO FARM ROAD ONTONAGON, MI 49953 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.01% |
| EVELYN GARCIA3 | 1562 1ST AVE NEW YORK, NY 10028 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.01% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.01% |
| BARRY W MAAS3 | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $2 | $11 | 0.01% |
| PAUL WAYNE GUILLOT3 | 8829 SHIRLEY-FRANCIS SHREVEPORT, LA 71129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| GREYHAVENS CONSULTING LLC3 | 1313 E MAPLE STREET BELLINGHAM, WA 98225 | 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% |
| YOLO ENTERPRISE INC3 | 2581 HILLCREST ST SIGNAL HILL, CA 90755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.00% |
| ANN LAURA TRICHEL3 | 223 CREEKSTONE DR WEST MONROE, LA 71291 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| ELEE TRICHEL3 | PO BOX 2447 MONROE, LA 71207 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| KEVIN FITZGERALD HOWARD3 | 3902 HATHAWAY AVE LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.00% |
| SADIE BLACKMON3 | 627 RAPIDS RD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 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 | 22500 LUCERNE DR SOUTHFIELD, MI 48075 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| DAVID M RYDEN3 | 2950 BENT TREE HILLS DR NEW BRIGHTON, MN 55112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 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 | 1727 WEST GREENHEAD DR MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| BSK BENEFITS PLUS LLC3 | 205 PINECREST DR COVINGTON, LA 70433 | 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 | 1412 PENINSULA PT AVE LAS VEGAS, NV 89123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| HELEN RODRIGUEZ-BURTON3 Filed as: HELEN RODRIGUES-BURTON | 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 | $336 | — | $336 | 4.74% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | THE PAUL REVERE LIFE INSURANCE COMPANY | $239 | $170 | $409 | 10.08% |
| DOUGLAS LOYAL NERDAHL3 Filed as: DOUGLAS LOYAL NERDAHT | 41 WEST 4TH AVE SAM MATEO, CA 94402 | THE PAUL REVERE LIFE INSURANCE COMPANY | $48 | $0 | $48 | 1.18% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | THE PAUL REVERE LIFE INSURANCE COMPANY | $40 | $0 | $40 | 0.99% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | THE PAUL REVERE LIFE INSURANCE COMPANY | $31 | $3 | $34 | 0.84% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | THE PAUL REVERE LIFE INSURANCE COMPANY | $20 | $0 | $20 | 0.49% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | THE PAUL REVERE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 0.25% |
| DANA MARIE MOWATT3 Filed as: DANA MARIA MOWATT | 23701 S WESTERN AVE #112 TORRENCE, CA 90501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $8 | $1 | $9 | 0.22% |
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W FIFTH ST. OXNARD, CA 93030 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.12% |
| JAKORP INC3 | 15254 WINESPRINGS CT SAN DIEGO, CA 92127 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.05% |
| INSGROUP INC3 Filed as: THE INSURANCE GROUP DBA BARKLE | 143 W 5TH ST OXNARD, CA 93030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $306 | — | $306 | 10.82% |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS OF CALIFORNIA | 98 | $515K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 83 | $7K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 305 | $122K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 172 | $119K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 98 | $515K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 305 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.