| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | DELTA DENTAL OF CALIFORNIA | — | — | $0 | 0.00% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | 0.00% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | 0.00% |
| GLEN E MILLER4 | 8566 FALLBROOK CIRCLE HUNTINGTON BEACH, CA 92646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $58 | $10K | 8.58% |
| GROUP SUPPLEMENTAL BENEFITS INC4 Filed as: GROUP SUPPLEMENTAL BENEFITS, INC | 31805 TEMECULA PARKWY #288 TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 4.05% |
| MICHELLE ANN REESE4 | 9000 SPRING RD COLTON, CA 92324 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $990 | $40 | $1K | 0.88% |
| JANE CONKLIN MILLER4 | 8566 FALLBROOK CIRCLE HUNTINGTON BEACH, CA 92646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $384 | — | $384 | 0.33% |
| BROWN AND BROWN OF FLORIDA, INC.4 Filed as: WILLIAM BROWN | 32997 CASALA CT TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $290 | $75 | $365 | 0.31% |
| JOHN CURTIS RICHERT4 | 183 SAWGRASS LN CALIMESA, CA 92320 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | $20 | $59 | 0.05% |
| ADVANCED BENEFIT CENTER, INC.4 Filed as: ADVANCED BENEFIT CENTER INC | 16145 WHITTIER BLVD WHITTIER, CA 90603 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.04% |
| ERIC TERRAZAS4 | 217 LOIS ST LA HABRA, CA 90631 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.04% |
| SANDRA MARIE MARINELLI4 | 26520 KEISSEL ROAD COLTON, CA 92324 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| MICHAEL F FAHEY III4 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| BOB BLAKE & ASSOCIATES INC4 | BOB BLAKE AND ASSOCIATES LONG BEACH, CA 90802 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| ANDRE CRENSHAW4 | 19605 TALISMAN STREET TORRANCE, CA 90503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| CYNTHIA L. MOHON4 | 15 N. MICHIGAN ST. REDLANDS, CA 92373 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $411 | — | $411 | 6.05% |
| DEBRA OTTEN4 Filed as: DEBRA L. OTTEN | 123 BRISTOL LN. MAPLES, FL 34112 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $223 | — | $223 | 3.28% |
| PAM MROZ4 | 6770 BRADFORD CT CHINO, CA 91710 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $54 | — | $54 | 0.79% |
| NANCY O. LEWIS4 | 2387 GRACE ST. RIVERSIDE, CA 92504 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $28 | — | $28 | 0.41% |
| PATRICIA SWANSON4 | 579 W. LEMON AVE. MONROVIA, CA 91016 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $5 | — | $5 | 0.07% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OCEA EIN 95-1685796 SALARIED ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $780K |
| DELTA DENTAL EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $383K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $169K |
| DIMARTINO ASSOCIATES EIN 91-0378940 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $99K |
| HEMMING MORSE EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $22K |
| HIGHLAND CAPITAL ADVISORS LLC EIN 20-4284376 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $15K |
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 | 11,301 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,382 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,683 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 12,314 | $2.4M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 24,000 | $1.4M |
| Short-term disability | STANDARD INSURANCE COMPANY | 13,170 | $698K |
| Long-term disability(2 contracts) | STANDARD INSURANCE COMPANY | 14,371 | $2.0M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 86 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 24,000 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.