| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 92606 | BLUE CROSS OF CALIFORNIA | $92K | — | $92K | 3.94% |
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 926065116 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | $2K | $16K | 6.92% |
| RAMONA MARGARET DALY3 | 3407 SOUTH MAIN STREET SANTA ANA, CA 92707 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $44 | $1K | 5.55% |
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 92606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 5.51% |
| CYNTHIA MARINA INGLE3 | 1834 KNAPP DRIVE VISTA, CA 92084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $403 | $7 | $410 | 1.70% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $226 | $166 | $392 | 1.62% |
| SHANIKA M. FISKE3 Filed as: SHANIKA M FISKE | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $15 | $71 | 0.29% |
| RONDA LEE SUTO3 | 2211 N. POINSETTIA STREET SANTA ANA, CA 92706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.25% |
| TINA HERNANDEZ3 | 11779 W COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $10 | $41 | 0.17% |
| JOSEPH RUBINO3 | 2490 GROSSMONT COLLEGE DRIVE EL CAJON, CA 92020 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.15% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.10% |
| RACHEL DARLENE DUBE3 | 1 PEBBLEWOOD IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.09% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.07% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 309 | $2.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 322 | $233K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 294 | $72K |
| Life insurance(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 322 | $329K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 294 | $97K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 294 | $97K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 309 | $2.3M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 294 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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.