| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | BLUE CROSS OF CALIFORNIA | $35K | — | $35K | 4.97% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | BLUE CROSS OF CALIFORNIA | — | $16K | $16K | 2.23% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | STARMOUNT LIFE INSURANCE COMPANY | $6K | $773 | $6K | 11.35% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | STARMOUNT LIFE INSURANCE COMPANY | $3K | $186 | $3K | 5.33% |
| BRITTANY LLOYD3 | PO BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $435 | $82 | $517 | 2.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $417 | — | $417 | 2.06% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $278 | — | $278 | 1.37% |
| STEPHANIE NOELLE KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $178 | $11 | $189 | 0.93% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | $38 | $139 | 0.69% |
| BRIAN ROBERT LLOYD3 | 3053 COPPERWOOD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | $32 | $133 | 0.66% |
| GENA LYNNE MOORE3 | 3254 VALLEY LN S COLUMBUS, OH 43231 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $118 | — | $118 | 0.58% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.26% |
| PAMELA KAY LONG3 | 200 S. LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $3 | $36 | 0.18% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVENUE SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.14% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $217 | $2K | 11.34% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $809 | $46 | $855 | 5.28% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 132 | $712K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 132 | $770K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 132 | $770K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $16K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $16K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 124 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.