| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | BLUE CROSS OF CALIFORNIA | $89K | $773 | $90K | 5.05% |
| RONALD WANGLIN3 | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 9.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.25% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $567 | $2K | 4.92% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $441 | $85 | $526 | 1.57% |
| ERIC NOVOA3 | 17871 SHADY VIEW DRIVE CHINO HILLS, CA 91709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $148 | $56 | $204 | 0.61% |
| ARIAN E NAWABI3 Filed as: ARIAN E. NAWABI | 201 DARLINGTON IRVINE, CA 92620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $194 | $6 | $200 | 0.60% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | $1 | $143 | 0.43% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 W. 187TH PLACE TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 0.33% |
| MARIA VERONICA JARQUE3 | 4085 NOBEL DRIVE, #29 SAN DIEGO, CA 92122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.22% |
| ALISHA JOHNSON3 | 1355 S. 24TH STREET FORT DODGE, IA 50501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 0.22% |
| SALLY ANN PRICE3 | 204 BREWER STREET LAKOTA, IA 50451 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 0.21% |
| RICHARD J GINTHER3 Filed as: RICHARD J. GRINTHER | 4220 LINCOLN AVENUE DES MOINES, IA 50310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | — | $64 | 0.19% |
| JOSEPH P CALARCO3 Filed as: JOSEPH MICHAEL EVANS | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $13 | $24 | 0.07% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.07% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM COURT MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $1 | $23 | 0.07% |
| JERRI J GREGORY3 Filed as: JERRI J. GREGORY | 791 NW 43RD AVENUE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $8 | $19 | 0.06% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $10 | $19 | 0.06% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON STREET FILOMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $2 | $13 | 0.04% |
| DUSTIN SNYDER3 | 34606 SHALLOT DRIVE WINCHESTER, CA 92596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.04% |
| JOHN CHARLES BOWERS3 | 4111 CHEVY CHASE DRIVE LA CANADA, CA 91011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| CAITLIN ELIZABETH HIRCHMAN3 | 6012 E. LA PAZ CIRCLE ANAHEIM, CA 92807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.03% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| GABRIEL HOLGUIN3 | 2807 GRATTON STREET RIIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| TINA HERNANDEZ3 | 6442 ROSTRATA STREET BUENA PARK, CA 90621 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| RONALD WANGLIN3 | P.O. BOX 6030 PASADENA, CA 911026030 | SAFEGUARD HEALTH PLANS, INC. | $1K | — | $1K | 7.88% |
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 | 212 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 264 | $1.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 131 | $98K |
| Vision | BLUE CROSS OF CALIFORNIA | 264 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 264 | $1.9M |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 44 | $34K |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 264 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.