| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | CALIFORNIA PHYSICIANS' SERVICE | $9K | $54K | $63K | 4.49% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1001 MARK AVE, SUITE 201 CARPENTERIA, CA 93013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $696 | — | $696 | 5.15% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $422 | $29 | $451 | 3.34% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $213 | — | $213 | 1.58% |
| CONCIERGE BENEFITS & INSURANCE SERV3 | 925 NORTH VULCAN AVE ENCINITAS, CA 92024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | $3 | $176 | 1.30% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $37 | $164 | 1.21% |
| RACHAEL DARLENE DUBE3 | 1 PEBBLEWOOD IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $21 | $124 | 0.92% |
| RAMONA MARGARET DALY3 | 3407 SOUTH MAIN STREET SANTA ANA, CA 92707 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.65% |
| PAMELA MARIE CONWAY3 | 33651 WINDHAM DR DANA POINT, CA 92629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.53% |
| MICHAEL F FAHEY III3 | 9301 NW 33RD ST DORAL, FL 33172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $7 | $61 | 0.45% |
| JUSTIN INGLE3 | 26661 VIA SACRAMENTO CAPISTRANO BEACH, CA 92624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.39% |
| CURTIS ALBERTO CANETT3 | 21901 JINETES MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.13% |
| SHANIKA M. FISKE3 Filed as: SHANIKA M FISKE | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $3 | $12 | 0.09% |
| TINA HERNANDEZ3 | 11779 W COCOPAH ST AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $2 | $7 | 0.05% |
| VALOR BENEFITS3 | 12125 KOUDEKERK ST ARTESIA, CA 90701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | ZURICH AMERICAN INSURANCE COMPANY | $428 | — | $428 | 15.00% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 108 | $1.4M |
| Dental | CALIFORNIA PHYSICIANS' SERVICE | 108 | $1.4M |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 108 | $1.4M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 129 | $56K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 11 | $14K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 129 | $56K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 108 | $1.4M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 140 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.