| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCEASSOCIATES INC | 1451GRANT RD SUITE 200 MOUNTAIN VIEW, CA 94040 | BLUE CROSS OF CALIFORNIA | $0 | $48K | $48K | 1.10% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURNACE ASSOCIATES, INC. | 1451 GRANT RD SUITE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 2.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT RD. SUITE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.00% |
| BRITTANY LLOYD3 | P.O. BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $5K | $11K | 26.05% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $395 | $1K | $2K | 3.72% |
| BRIAN ROBERT LLOYD3 | 3053 COPPERWOOD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $369 | $857 | $1K | 2.98% |
| STEPHANIE NOELLE KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $672 | $289 | $961 | 2.34% |
| ASSUREDPARTNERS3 Filed as: DWIGHT ANDRUS INS AGENCY INC | PO BOX 60970 LAFAYETTE, LA 70596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.22% |
| SCOTT J CHAMBERS3 | 609 EMMELINE ST NEW IBERIA, LA 70560 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.06% |
| JOEY MIGUES3 | 103 BALTUSROL DRIVE BROUSSARD, LA 70518 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.05% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.04% |
| ADVANCE INSURANCE AGENCY INC3 | 5241 VIKING DRIVE EDINA, MN 55435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| GROUP VOLUNTARY BENEFITS LLC3 | 29103 CHURCH OF GOD RD SPRINGFIELD, LA 70462 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.03% |
| JODIE C MIGUES3 | 103 BALTUSROL DR BROUSSARD, LA 70518 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| PAT E KELLEY3 | 2009 W BEAUREGARD AVE SAN ANGELO, TX 76901 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| ANNELLA MARTIN3 | 730 LAKEVIEW DR COLEMAN, TX 76834 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| BRIAN WHITE3 Filed as: BRIAN R MADTES | 1308 JAMES COOK WINDCREST, TX 78239 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DEBORAH S GOLDEN3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| TED BENNETT3 | 1830 DESTINY LANE BOWLING GREEN, KY 42104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| REBECCA N SONGY3 | 6900 MEMPHIS STREET NEW ORLEANS, LA 70124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GPS INSURANCE AGENCY LLC3 | PO BOX 489 WINTERS, TX 79567 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| THOMAS SNYDER3 | 10539 DEDEKE DR NEW BRAUNFELS, TX 78132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | BLUE CROSS OF CALIFORNIA | 344 | $4.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 420 | $436K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 401 | $4.4M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 504 | $294K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 504 | $294K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 504 | $253K |
| Prescription drug(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 344 | $4.8M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 504 | $372K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.