| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AARON MAY3 | 16755 VON KARMAN AVE SUITE 200 IRVINE, CA 92606 | ANTHEM BLUE CROSS | $21K | — | $21K | 2.73% |
| AMWINS3 Filed as: AMWINS CONNECT INS SRV LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | ANTHEM BLUE CROSS | — | $17K | $17K | 2.25% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD SUITE 800 CONCORD, CA 94520 | ANTHEM BLUE CROSS | $5K | — | $5K | 0.66% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 2.36% |
| AARON MAY3 | 16755 VON KARMAN AVE STE 200 IRVINE, CA 926064963 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 2.16% |
| AMWINS3 Filed as: AMWINS CONNECT INS SRV, LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 1.71% |
| AARON MAY3 | 16755 VON KARMAN AVE STE 200 IRVINE, CA 926064963 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 7.21% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 945207924 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 6.45% |
| AMWINS3 Filed as: AMWINS CONNECT INS SRV | 2 ENTERPRISE DR STE 204 SHELTON, CT 064844657 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.79% |
| AARON MAY3 | 16755 VON KARMAN AVE STE 200 IRVINE, CA 92606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 15.83% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $1K | $11K | 15.25% |
| JOHN D EVANGELISTA3 | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 7.83% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVE STE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $569 | $2K | 3.04% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LN ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $38 | $2K | 2.85% |
| ACRIAPLS LLC3 | C/O ACRIALPS LLC GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $208 | $2K | 2.43% |
| TECH COORDINATOR CYBER INSURANCE SO3 Filed as: TECH COORDINATOR CYBER INS SO | 10741 LA JARA ST CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $323 | $1K | 1.85% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $565 | — | $565 | 0.77% |
| RELATIONAL ADVISORS, LLC3 Filed as: RELATIONAL ADVISORS LLC | 5151 CALIFORNIA AVE IRVINE, CA 92617 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $328 | — | $328 | 0.45% |
| UBC INSURANCE SOLUTIONS INC3 | 18300 VON KARMAN IRVINE, CA 92612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $191 | — | $191 | 0.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 28202 CABOT RD LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.18% |
| MARLINA JACKSON3 | 7650 WHISPER WAY REUNION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 0.16% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR ST LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | $33 | $116 | 0.16% |
| CHERYL LYNN GAONA3 | 11912 KILLIAN ST EL MONTE, CA 91732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $6 | $108 | 0.15% |
| JB CREATIVE SOLUTIONS LLC3 | 3881 FREEMAN WAY PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | — | $89 | 0.12% |
| DOMINICK R SIRACUSA3 Filed as: DOMINICK MICHAEL SORRENTINO | 9110 W TROPICANA AVE LAS VEGAS, NV 89147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $3 | $87 | 0.12% |
| CHELSEA L WARE LLC3 | 233 W 21ST ST NEW YORK, NY 10011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 0.12% |
| TERRELL & COMPANY INC3 Filed as: TERRELL AGENCY INC | 1644 STUBBS VINSON RD MONROE, LA 71203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $25 | $84 | 0.11% |
| KIM REED SMITH3 Filed as: KIM R TERRELL | 1644 STUBBS VINSON RD MONROE, LA 71203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.05% |
| DAVID O CHRISTENSEN3 | 396 CYPRESS DR APT F LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.05% |
| RAYMOND KWOCKMAN GONG3 | 1907 COLUMBIA ST APT 501 SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $5 | $24 | 0.03% |
| ANTONIA DAVILA3 Filed as: ANTONIA MARIA HOLDEN | 8932 CREEKFORD DR LAKESIDE, CA 92040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.03% |
| CINDY V SHIELDS3 Filed as: CINDY PAMELA REYES-MEDINA | 2617 RIALTO RD LAS VEGAS, NV 89108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.03% |
| ROGER STUART KENCHEL3 | 2588 EL CAMINO REAL STE F188 CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| ZACHAREE KEITH SIAHPUSH3 | 6727 MLK JR WAY S STE M SEATTLE, WA 98118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $1 | $17 | 0.02% |
| CHERYL JONETTE GAILEY3 | 57 CHRYSANTHEMUM DR ORMOND BEACH, FL 32174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.02% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F FAHEY LII | 103 PALM DR SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| ASSUREDPARTNERS3 Filed as: JENNIFER RENEE BLAIR | 3949 CARLA ANN RD NORTH LAS VEGAS, NV 89081 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| THINK IN MARKETING AGENCY LLC3 | 18270 OLIVER TWIST WAY WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $4 | $9 | 0.01% |
| NICHOLAS J WOOG3 | 5510 SEWARD PARK AVE SEATTLE, WA 98118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| HOWARD DWIGHT RINCON3 | 4531 JUDY CT ORLAND, FL 32839 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $2 | $7 | 0.01% |
| DANIEL GRIFFON3 | 2311 AMALIE DR MONROE, LA 71201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| KRISTIN ANN DECOU3 | 751 ROBIN GLEN RD BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JORDAN TEDESCO3 | 1412 6TH AVE N SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.01% |
| SHARON ABADI3 | 1835 NE MIAMI GARDEN DR NORTH MIAMI BEACH, FL 33180 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| MONYE GROUP INC3 | 1835 NE MIAMI GARDENS DR NORTH MIAMI BEACH, FL 33180 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| ALEXANDRA DIANE SORRENTINO3 | 3055 RED SPRINGS DR LAS VEGAS, NV 89135 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DR MURRIETA, CA 92562 | 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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 96 | $898K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 178 | $109K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 178 | $109K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 96 | $898K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 56 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.