| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $68K | — | $68K | 4.33% |
| RONALD WANGLIN3 | P.O. BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 10.28% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $4K | $6K | 16.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 12.44% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $921 | $457 | $1K | 3.89% |
| ARIAN E NAWABI3 Filed as: ARIAN E. NAWABI | 201 DARLINGTON IRVINE, CA 92620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $670 | $192 | $862 | 2.43% |
| ERIC NOVOA3 | 17871 SHADY VIEW DR. CHINO HILLS, CA 91709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $621 | $13 | $634 | 1.79% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $582 | $10 | $592 | 1.67% |
| SALLY ANN PRICE3 | 204 BREWER ST. LAKOTA, IA 50451 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $468 | $34 | $502 | 1.42% |
| ALISHA JOHNSON3 | 1355 S. 24TH ST. FORT DODGE, IA 50501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $367 | — | $367 | 1.04% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM CT. MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $162 | $21 | $183 | 0.52% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST. NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $108 | $159 | 0.45% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | $8 | $113 | 0.32% |
| JOSEPH P CALARCO3 Filed as: JOSEPH MICHAEL EVANS | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $43 | $106 | 0.30% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 W. 187TH PL. TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 0.29% |
| JERRI J GREGORY3 Filed as: JERRI J. GREGORY | 791 NW 43RD AVENUE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $31 | $94 | 0.27% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON ST. FILLMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $29 | $75 | 0.21% |
| RICHARD J GINTHER3 Filed as: RICHARD J. GINTHER | 4220 LINCOLN AVENUE DES MOINES, IA 50310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.17% |
| BYRON A BROWDER3 Filed as: BYRON A. BROWDER | 791 NW 43RD AVENUE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.17% |
| CAITLIN ELIZABETH HIRCHMAN3 | 6012 E. LA PAZ CIR. ANAHEIM, CA 92807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.14% |
| JOHN CHARLES BOWERS3 | 4111 CHEVY CHASE DR. LA CANADA, CA 91011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.13% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.06% |
| MARTIN MENDOZA3 | 26443 SAND PALM CT. MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.06% |
| GABRIEL HOLGUIN3 | 2807 GRATTON ST. RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| DUSTIN SNYDER3 | 34606 SHALLOT DR. WINCHESTER, CA 92596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| JAKORP INC3 Filed as: JAKORP INC. | 15254 WINESPRINGS CT. SAN DIEGO, CA 92127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | P.O. BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.01% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES INC. | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| TINA HERNANDEZ3 | 6442 ROSTRATA ST. BUENA PARK, CA 90621 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.01% |
| RONALD WANGLIN3 | P.O. BOX 6030 PASADENA, CA 91102 | SAFEGUARD HEALTH PLANS, INC. | $1K | — | $1K | 8.53% |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 217 | $1.6M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 129 | $91K |
| Vision | BLUE CROSS OF CALIFORNIA | 217 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 217 | $1.6M |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 58 | $35K |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 217 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.