| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLANT RISK & INSURANCE SERVICES3 Filed as: GALLANT RISK & INSURANCE SERVICES I | 4106 TEMESCAL CANYON RD STE 40 CORONA, CA 92883 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 6.81% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $1K | $7K | 6.28% |
| GALLANT RISK & INSURANCE SERVICES3 Filed as: GALLANT RISK & INSURANCE SERVICES I | 4160 TEMESCAL CANYON RD CORONA, CA 92883 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 4.63% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $966 | $4K | 3.48% |
| STACI MARIE FERRARIS3 | 28912 GLEN ROCK PLACE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $315 | $4K | 3.25% |
| INVENSURE INSURANCE BROKERS, INC.3 Filed as: INVENSURE INSURANCE BROKERS INC | 17991 COWAN IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.04% |
| STEPHEN W DOUGLASS3 | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $54 | $1K | 0.98% |
| NICOLE ANGELES RAMIREZ3 | 201 N ATLANTIC BLVD #A ALHAMBRA, CA 91801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $689 | $177 | $866 | 0.75% |
| GABRIEL HOLGUIN3 | 2807 GRATTON ST RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $678 | $133 | $811 | 0.71% |
| RAMONA MARGARET DALY3 | 402 CAMINO BANDERA SAN CLEMENTE, CA 92673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $661 | — | $661 | 0.58% |
| LAURA LENEE KELLY3 Filed as: LAURA LENEE SELF | 4 THOUSAND OAKS CIR CONWAY, AR 72032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $504 | — | $504 | 0.44% |
| MIKE MCCORMICK3 | 348 S STRONGS CT SALT LAKE CITY, UT 84102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $212 | — | $212 | 0.18% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $191 | — | $191 | 0.17% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G STOKES | 3113W 187TH P1 TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $185 | — | $185 | 0.16% |
| ALI ALEX ROUSHANZAMIR3 | 1639 SPYGLASS DRIVE CORONA, CA 92883 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | — | $156 | 0.14% |
| UZIEL RIVERA3 | 543 CHEROKEE CIR BANNING, CA 92220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | $27 | $141 | 0.12% |
| LUIS ERNESTO PEREZ3 | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | $11 | $140 | 0.12% |
| KYLE HARDING3 | 105 EAST BROAD ST TEXARKANA, AR 71854 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $68 | $110 | 0.10% |
| LIFE TIME SOLUTIONS LLC3 | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $96 | — | $96 | 0.08% |
| RYAN THURSTON WHITTAKER3 | 33011 COMMODORE CT SAN JUAN CAPO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.05% |
| REGINA SWINNEA3 | 611 E LOOP 499 HARLINGEN, TX 78550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | P 0 BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.04% |
| LAMBERT MONTALBO3 | 26197 MIRADA ST HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $2 | $32 | 0.03% |
| METRO COAST INSURANCE SERVICES LLC3 | 39 AUBRIETA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $3 | $24 | 0.02% |
| ZACHARY MULLINS3 | 39 COMMENTRY DR LITTLE ROCK, AR 72223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.02% |
| SALAZAR INSURANCE GROUP LLC3 | 611 E LOOP 499 HARLINGEN, TX 78550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.00% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| JORGE RIESTRA3 | 2800 KELLER DR TUSTIN CITY, CA 92782 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| GINGER MULLINS & COMPANY INC3 | 1701 CENTERVIEW DRIVE LITTLE ROCK, AR 72211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 32101 FALL RIVER ROAD TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| DONNA SWINNEA3 | 611 E LOOP 499 HARLINGEN, TX 78550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| G SCOTT COOKE3 Filed as: SCOTT C CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| DELORES J KARISCH3 | PO BOX 35 SMITHVILLE, TX 78957 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLANT RISK & INSURANCE SERVICES INSURANCE AGENT | Insurance services; Insurance agents and brokers Service code 22 | 4160 TEMESCAL CANYON ROAD, STE 402 CORONA, CA 92883 | $86K |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 310 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 310 | $3.0M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 310 | $3.0M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 316 | $233K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 316 | $233K |
| Long-term disability | STANDARD INSURANCE COMPANY | 316 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.