| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | GUARDIAN LIFE INSURANCE COMPANY | $14K | $7K | $21K | 10.15% |
| DAVID O CHRISTENSEN3 | 180 MCKNIGHT DRIVE LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $3K | $13K | 12.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA SHOREPOINT INSURANCE SERVICE COSTA MESA, CA 92626 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $876 | $5K | 5.01% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F FAHEY | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $469 | $3K | 2.59% |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $291 | $3K | 2.58% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $510 | $2K | 1.80% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $56 | $2K | 1.77% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $504 | $2K | 1.73% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST SUITE 1200 WOODLAND HILLS, CA 91367 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $18 | $1K | 1.20% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON ST RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $510 | $129 | $639 | 0.61% |
| ERIC TERRAZAS3 | 217 LOIS ST LAHABRA, CA 90631 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $619 | — | $619 | 0.59% |
| ELTHON ISRAEL CRUZ3 Filed as: ELTHON ISREAL CRUZ | 3800 WEST DEVONSHIRE AVENUE HEMET, CA 92545 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $501 | $10 | $511 | 0.49% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $340 | $26 | $366 | 0.35% |
| NISSAH LIA AGUILAR3 | 33556 MAPLEWOOD CT TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $334 | — | $334 | 0.32% |
| JUSTIN INGLE3 | 26661 VIA SACRAMENTO CAPISTRANO BEACH, CA 92624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $239 | $37 | $276 | 0.26% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $197 | $74 | $271 | 0.26% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $114 | $159 | 0.15% |
| ARIAN E NAWABI3 | 201 DARLINGTON IRVINE, CA 92620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | $2 | $156 | 0.15% |
| DAVID A. RACKLIFFE3 Filed as: DAVID A RACKLIFFE | 300 HEROIT CT SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $145 | $9 | $154 | 0.15% |
| TIM CHRISTOPHER ELLIS3 | P.O. BOX 483 ORANGE, CA 92856 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | $1 | $100 | 0.10% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $15 | $86 | 0.08% |
| LAMBERT MONTALBO3 | 26197 MIRADA ST HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | — | $82 | 0.08% |
| LIFE TIME SOLUTIONS LLC3 | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.07% |
| EUNICE AKIAN3 | 15551 WILD PLUM CIRCLE HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $8 | $59 | 0.06% |
| CURTIS ALBERTO CANETT3 | 21901 JINETES MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.05% |
| TINA HERNANDEZ3 | 11779 W COCOPAH ST AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $8 | $29 | 0.03% |
| JENNIFER AURORA RAMIREZ3 | 1053 FICUS LANE SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| SHANIKA M. FISKE3 Filed as: SHANIKA M FISKE | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $9 | $21 | 0.02% |
| VALOR BENEFITS3 | 12125 KOUDEKERK STREET ARTESIA, CA 90701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $4 | $14 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA MCQUEARY HENRY BOWLES TROY DALLAS, TX 75231 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.01% |
| VIRGINIA LEDER-CLARK3 | 5213 MARSHALL CRK FLOWER MOUND, TX 75028 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BLVD DULUTH, GA 30096 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MPART BENEFITS INC3 | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL RD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| RACHAEL DARLENE DUBE3 | 1 PEBBLEWOOD IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 8.78% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | GUARDIAN LIFE INSURANCE COMPANY | $580 | — | $580 | 4.57% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | AMERICAN UNITED LIFE INSURANCE COMPANY | $115 | — | $115 | 11.63% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1120 BRISTOL ST COSTA MESA, CA 92626 | AMERICAN UNITED LIFE INSURANCE COMPANY | $34 | — | $34 | 3.44% |
| DAVID O CHRISTENSEN3 | 180 MCKNIGHT DRIVE LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $521 | $214 | $735 | — |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F FAHEY | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | $34 | $162 | — |
| ERIC ALEXANDER NOVOA3 | 17871 SHADY VIEW DR CHINO HILLS, CA 91709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $111 | $17 | $128 | — |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA SHOREPOINT INSURANCE SERVICE COSTA MESA, CA 92626 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | $20 | $119 | — |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $4 | $35 | — |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $22 | $31 | — |
| TINA HERNANDEZ3 | 11779 EW COCOPAH ST AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $3 | $12 | — |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 253 | $2.0M |
| Dental(2 contracts) | GUARDIAN LIFE INSURANCE COMPANY | 299 | $215K |
| Vision(2 contracts) | GUARDIAN LIFE INSURANCE COMPANY | 299 | $215K |
| Life insurance(4 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY | 299 | $320K |
| Short-term disability(4 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 157 | $118K |
| Long-term disability(2 contracts) | GUARDIAN LIFE INSURANCE COMPANY | 299 | $215K |
| Other(4 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY | 299 | $320K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.