| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | SYMETRA LIFE INSURANCE COMPANY | $0 | $12K | $12K | 1.87% |
| BRITTANY LLOYD3 | PO BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $3K | $8K | 9.24% |
| MJ INSURANCE3 Filed as: 3C HOLDINGS AND VARIOUS AGENTS | 908 SYDNEY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $241 | $3K | 3.89% |
| CASEY JAMES KUGLER3 Filed as: CASEY KUGLER | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $531 | $1K | $2K | 1.93% |
| BRIAN ROBERT LLOYD3 Filed as: BRIAN LLOYD | 3053 COPPERWOOD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $688 | $593 | $1K | 1.46% |
| STEPHANIE NOELLE KUGLER3 Filed as: STEPHANIE KUGLER | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $935 | $249 | $1K | 1.35% |
| MARGARITA ALEJANDRA RAMIREZ3 Filed as: MARGARITA RAMIREZ | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $732 | $286 | $1K | 1.16% |
| NAOMI R HALL3 Filed as: NAOMI HALL | 1930 EAST HAROLD AVENUE VISALIA, CA 93292 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $704 | $0 | $704 | 0.80% |
| BRIAN ROBERT LLOYD3 Filed as: BRIAN LLOYD | 3053 COPPERWOOD WAY EL DORADO HILLS, KY 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 1.86% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL LLC | 2305 RIVER ROAD LOUISVILLE, KY 40206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.85% |
| MJ INSURANCE3 Filed as: GARY HARDEMAN AND VARIOUS AGENTS | 16810 CORALBEND DRIVE HOUSTON, TX 77095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.85% |
| MAYNARD BENEFITS GRP INC3 Filed as: MAYNARD BENEFITS GROUP | PO BOX 9115 NORTH MYRTLE BEACH, SC 29582 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.50% |
| CASEY JAMES KUGLER3 Filed as: CASEY KUGLER | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.40% |
| MARY KOCH3 | 3303 TAYSIDE CROSSING NW KENNESAW, GA 30152 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.35% |
| PATRICIA A HERLONG3 Filed as: PATRICIA HERLONG | 8 CROSSBOW PLACE COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.30% |
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 | 1,281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 155 | $1.3M |
| Vision | VISION SERVICE PLAN | 815 | $91K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 1,245 | $631K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 1,245 | $631K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 1,245 | $631K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 155 | $1.3M |
| Other(3 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,245 | $721K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,245 | — |
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.