| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | AETNA HEALTH, INC. | $61K | — | $61K | 3.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | AETNA LIFE INSURANCE CO. | $13K | $4K | $17K | 10.53% |
| EDWARD J THURIN3 | 19899 RAY AVE RIVERSIDE, CA 92508 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.68% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM CT MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $72 | $1K | 3.57% |
| JOHN HENRY GARCIA3 | 39195 REGENCY WAY PALM DESERT, CA 92211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.49% |
| DEBORAH RUSH KIMMONS3 | 37291 BOSLEY ST INDIO, CA 92203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $770 | $214 | $984 | 3.02% |
| LORI LAINE3 | 35837 CARTER ST YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $372 | $107 | $479 | 1.47% |
| WANDA MCGINTY3 | 29075 RED TAIL CT HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $183 | — | $183 | 0.56% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $94 | $178 | 0.55% |
| COURTNEY MCFARLAND3 | 852 BAYWOOD DR NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $47 | $147 | 0.45% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE ST LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | $5 | $133 | 0.41% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE RD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.37% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNADINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | — | $82 | 0.25% |
| KATHLEEN SPILLMAN-OREL3 | 1499 OLD MOUNTAIN RD SAN JACINTO, CA 92583 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.19% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.15% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.12% |
| ELTHON ISRAEL CRUZ3 | 3800 WEST DEVONSHIRE AVE HEMET, CA 92545 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.12% |
| GCG FINANCIAL LLC3 Filed as: TERRANCE HUGH DICKERSON | 34400 GLENWOOD DR YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $1 | $39 | 0.12% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $1 | $21 | 0.06% |
| BOELZNER AND ASSOC INS SVCS3 | PO BOX 269 PALM DESERT, CA 92261 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| MCCAREY INC3 | 965 MESA DR CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $5 | $9 | 0.03% |
| JACK F KIMMONS3 | 37291 BOSLEY ST INDIO, CA 92203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| TINA HERNANDEZ3 | 6442 ROSTRATA ST BUENA PARK, CA 90621 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.01% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN & ASSOCIATES | 11412 ROBBIA DR LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JOHN HENRY GARCIA3 | 39195 REGENCY WAY PALM DESERT, CA 92211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 4.25% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM CT MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $2 | $39 | 4.05% |
| DEBORAH RUSH KIMMONS3 | 37291 BOSLEY ST INDIO, CA 92203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $10 | $39 | 4.05% |
| EDWARD J THURIN3 | 19899 RAY AVE RIVERSIDE, CA 92508 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 3.42% |
| LORI LAINE3 | 35837 CARTER ST YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $3 | $14 | 1.45% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 0.62% |
| COURTNEY MCFARLAND3 | 852 BAYWOOD DR NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.52% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.41% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNADINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.31% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE RD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.21% |
| GCG FINANCIAL LLC3 Filed as: TERRANCE HUGH DICKERSON | 34400 GLENWOOD DR YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.10% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.10% |
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 | 390 | 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) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 390 | $163K |
| Dental | AETNA LIFE INSURANCE CO. | 390 | $163K |
| Vision | AETNA LIFE INSURANCE CO. | 390 | $163K |
| Life insurance(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 390 | $196K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 22 | $34K |
| Other(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 390 | $196K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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.