| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 400 GALLERIA PARKWAY, SUITE 300 ATLANTA, GA 30339 | BLUE CROSS OF CALIFORNIA | $60K | — | $60K | 2.17% |
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 92606 | BLUE CROSS OF CALIFORNIA | $43K | — | $43K | 1.54% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $6K | $11K | 5.44% |
| MOORE BENEFITS INC.3 | 7755 IRVINE CENTER DRIVE, SUITE 500 IRVINE, CA 926182903 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 3.03% |
| RAMONA MARGARET DALY3 | 3407 SOUTH MAIN STREET SANTA ANA, CA 92707 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $65 | $1K | 5.70% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $121 | $1K | 5.42% |
| ERIC ALEXANDER NOVOA3 | 17871 SHADY VIEW DRIVE CHINO HILLS, CA 91709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $387 | $87 | $474 | 2.28% |
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 92606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $289 | — | $289 | 1.39% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | $58 | $266 | 1.28% |
| RONDA LEE SUTO3 | 2211 N. POINSETTIA STREET SANTA ANA, CA 92706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $95 | — | $95 | 0.46% |
| CYNTHIA MARINA INGLE3 | 1834 KNAPP DRIVE VISTA, CA 92084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | — | $89 | 0.43% |
| SHANIKA M. FISKE3 Filed as: SHANIKA M FISKE | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $5 | $54 | 0.26% |
| TINA HERNANDEZ3 | 11779 W COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $12 | $54 | 0.26% |
| JOSEPH RUBINO3 | 2490 GROSSMONT COLLEGE DRIVE EL CAJON, CA 92020 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.09% |
| RACHEL DARLENE DUBE3 | 1 PEBBLEWOOD IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.08% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.06% |
| MICHAEL F FAHEY III3 | 9301 NW 33RD STREET DORAL, FL 33172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.06% |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.03% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 136 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 267 | $2.8M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 291 | $209K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 280 | $91K |
| Life insurance(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 291 | $320K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 280 | $111K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 280 | $111K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 267 | $2.8M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 280 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.