| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 FIFTH AVENUE, 15TH FLOOR SEATTLE, WA 98101 | BLUE CROSS OF CALIFORNIA | $150K | — | $150K | 1.49% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $102K | — | $102K | 8.37% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $137K | $38K | $174K | 15.03% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | EYEMED | $7K | — | $7K | 7.04% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET SAN DIEGO, CA 92101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $13 | $2K | 6.75% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $817 | $122 | $939 | 3.14% |
| MJ INSURANCE3 Filed as: DEIDRE B. HOEHN AND VARIOUS AGENTS | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $815 | $86 | $901 | 3.02% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $413 | $87 | $500 | 1.67% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $250 | $116 | $366 | 1.23% |
| DANA MARIE MOWATT3 | 23701 SOUTH WESTERN AVENUE SUITE 112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $239 | $35 | $274 | 0.92% |
| BRYCE ALEXANDER KORNGOLD3 | 25702 PATTERSON PLACE LAGUNA HILLS, CA 92653 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $176 | — | $176 | 0.59% |
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 | 1,129 | 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) | 1,144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 2,583 | $10.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,416 | $1.2M |
| Vision | EYEMED | 2,433 | $102K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,106 | $1.2M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,106 | $1.2M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,106 | $1.2M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 2,583 | $10.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,106 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,583 | — |
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.