| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOORE BENEFITS INC.3 | 18662 MACARTHUR BLVD., SUITE 480 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $72K | — | $72K | 3.77% |
| MOORE BENEFITS INC.3 | 18662 MACARTHUR BLVD., SUITE 480 IRVINE, CA 926121230 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $5K | $14K | 7.34% |
| MOORE BENEFITS INC.3 | 18662 MACARTHUR BLVD., SUITE 480 IRVINE, CA 926121230 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $2K | $10K | 17.89% |
| RAMONA MARGARET DALY3 | 402 CAMINO BANDERA SAN CLEMENTE, CA 92673 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $3K | $246 | $3K | 12.82% |
| MOORE BENEFITS INC.3 | 18662 MACARTHUR BLVD., SUITE 480 IRVINE, CA 92612 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 11.36% |
| CYNTHIA MARINA INGLE3 Filed as: CYNTHIA INGLE | 1834 KNAPP DRIVE VISTA, CA 92084 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $635 | $67 | $702 | 3.24% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $333 | $336 | $669 | 3.08% |
| SHANIKA M. FISKE3 Filed as: SHANIKA M FISKE | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $130 | $84 | $214 | 0.99% |
| RONDA LEE SUTO3 | 2213 MELODY LANE FULLERTON, CA 92831 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.43% |
| RACHAEL DARLENE DUBE3 | 1 PEBBLEWOOD IRVINE, CA 92604 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.31% |
| JOSEPH RUBINO3 | 1806 BRABHAM STREET EL CAJON, CA 92019 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.19% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.15% |
| MARIANNA REBECCA WEAVER3 | 1301 DOVE STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.15% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.07% |
| TINA HERNANDEZ3 | 6442 ROSTRATA STREET BUENA PARK, CA 90621 | COLONIAL LIFE ACCIDENT INSURANCE COMPANY | $8 | $6 | $14 | 0.06% |
| MOORE BENEFITS INC.3 | 18662 MACARTHUR BLVD., SUITE 480 IRVINE, CA 92612 | VISION SERVICE PLAN / HEALTHSMART BENEFIT SOLUTIONS, INC. | $2K | $75 | $2K | 11.63% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 288 | $1.9M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $186K |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 286 | $51K |
| Life insurance(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $300K |
| Short-term disability(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $263K |
| Long-term disability(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $263K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 288 | $1.9M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 286 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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.