| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | — | $32K | 3.04% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | $29K | — | $29K | 3.01% |
| AON CONSULTING INC3 Filed as: AON CONSULTING WORLDWIDE | 29840 NETWORK PLACE CHICAGO, IL 606731298 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $10K | $10K | 1.46% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 CHARLOTTE, NC 282905494 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $7K | $12K | 4.34% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | P.O. BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $10K | — | $10K | 4.12% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 CHARLOTTE, NC 282905494 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $4K | $30K | 17.74% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $360 | $2K | 4.41% |
| BENEFITS COORDINATOR3 | P.O. BOX 727 ARTESIA, CA 92702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $759 | $108 | $867 | 1.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON LLC | P.O BOX 29018 PORTLAND, OR 97296 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $574 | — | $574 | 1.07% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $566 | — | $566 | 1.06% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $442 | $118 | $560 | 1.05% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLAS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | — | $211 | 0.39% |
| BENJAMIN ACEVEDO3 | 16211 E. GROVECENTER STREET COVINA, CA 91722 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $200 | — | $200 | 0.37% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 17042 PINEHURST LN., UNIT D HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $146 | — | $146 | 0.27% |
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GROUP BENEFITS & INS. | P.O. BOX 26457 SANTA ANA, CA 92799 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.14% |
| RITA J ROBINSON3 Filed as: RITA J. ROBINSON | P.O. BOX 34 WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.08% |
| MARY ESTHER TAYLOR3 | P.O. BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.08% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 23522 VIA ALONDRA TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.05% |
| MARTHA R BAEZ3 Filed as: MARTHA R. BAEZ | 2179 OLD BRIDGE ROAD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $1 | $26 | 0.05% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.04% |
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 | 1,801 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,813 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 213 | $2.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,204 | $669K |
| Vision | HM LIFE INSURANCE COMPANY | 2,011 | $112K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,801 | $272K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 306 | $221K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 306 | $168K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,801 | $272K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,011 | — |
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."
No prospect flags tripped on this filing.