| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAYMOND MARKLEY3 | UNKNOWN RUBIDOUX, CA 92509 | CALIFORNIA CHOICE | $17K | $0 | $17K | 3.05% |
| GREGORY TALLEY3 | UNKNOWN RUBIDOUX, CA 92509 | CALIFORNIA CHOICE | $6K | $0 | $6K | 1.13% |
| DANA HARRISON3 | UNKNOWN RUBIDOUX, CA 92509 | CALIFORNIA CHOICE | $5K | $0 | $5K | 0.81% |
| DAVID O CHRISTENSEN3 Filed as: DAVID O. CHRISTENSEN | 396 CYPRESS DRIVE, APARTMENT F LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $2K | $10K | 10.13% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1120 BRISTOL STREET COSTA MESA, CA 92626 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $139 | $8K | 8.24% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $220 | $2K | 1.92% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND KWOCKMAN GONG AND OTHERS | 1907 COLUMBIA STREET SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $178 | $2K | 1.79% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $191 | $1K | 1.44% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $151 | $1K | 1.39% |
| LUZ CASTILLO BARRIGA3 | 22019 JUAN AVENUE HAWAIIAN GARDENS, CA 90716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $49 | $1K | 1.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1120 BRISTOL STREET COSTA MESA, CA 92626 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.78% |
| CONTRACTING PARTNERS LLC3 Filed as: CONTRACTING PARTNERS, LLC | PO BOX 646 ROSEVILLE, CA 95678 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.09% |
| BENEFITS MATCHMAKING LLC3 Filed as: BENEFITS MATCHMAKING, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT ADMINS, INC. | 721 SOUTH PARKER STREET, SUITE 300 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | $575 | $0 | $575 | 1.14% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 601 UNIVERSITY AVENUE, SUITE 250 SACRAMENTO, CA 95825 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $474 | $474 | 0.94% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $254 | $254 | 0.50% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | CALIFORNIA DENTAL NETWORK, INC. | $629 | $0 | $629 | 6.60% |
| CONTRACTING PARTNERS LLC3 Filed as: CONTRACTING PARTNERS | PO BOX 646 ROSEVILLE, CA 95678 | CALIFORNIA DENTAL NETWORK, INC. | $325 | $0 | $325 | 3.41% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 67 | $564K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $60K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $50K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 170 | $146K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 79 | $96K |
| Prescription drug | CALIFORNIA CHOICE | 67 | $564K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 170 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.