| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1550 17TH ST. SUITE 600 DENVER, CO 80202 | CALIFORNIA PHYSICIANS' SERVICE | $4K | $26K | $30K | 1.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $10K | $17K | $27K | 1.64% |
| IMA, INC.3 | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $3K | $21K | $24K | 1.42% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 17.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $455 | $130 | $585 | 4.49% |
| BLUE PACIFIC INSURANCE SERVICES3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $374 | $30 | $404 | 3.10% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF CALIFORNIA INC. | 1001 MARK AVE. SUITE 201 CARPINTERIA, CA 93013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $355 | — | $355 | 2.72% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DR. LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $308 | $39 | $347 | 2.66% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE ST. SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $74 | $183 | 1.40% |
| RACHAEL DARLENE DUBE3 | 9 FRANCES BARBER DR. HOPE VALLEY, RI 02832 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | $38 | $181 | 1.39% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B. STREET SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.69% |
| CONCIERGE BENEFITS & INSURANCE SERV3 Filed as: CONCIERGE BENEFITS & INSURANCE SVCS | 3535 LINDA VISTA DRIVE SAN MARCOS, CA 92078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.54% |
| KRISTIN LEASE3 | 3890 HOWARD AVE. LOS ALAMITOS, CA 90720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $37 | $51 | 0.39% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $6 | $47 | 0.36% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY LII | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.34% |
| RAMONA MARGARET DALY3 | 2877 CALLE HERALDO SAN CLEMENTE, CA 92673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.33% |
| J&H FINANCIAL AND INSURANCE SVC LLC3 Filed as: J&H FINANCIAL AND INSURANCE SVC. | 22948 VIA CEREZA UNIT 4E MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.31% |
| TINA HERNANDEZ3 | 11779 W. COCOPAH ST. AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $7 | $35 | 0.27% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $323 | $2K | 17.50% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 101 | $1.7M |
| Dental | CALIFORNIA PHYSICIANS' SERVICE | 101 | $1.7M |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 101 | $1.7M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $52K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 9 | $13K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $13K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 101 | $1.7M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.