| 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 MILLER3 | 8566 FALLBROOK CIRCLE HUNTINGTON BEACH, CA 92646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $48 | $8K | 7.04% |
| GROUP SUPPLEMENTAL BENEFITS INC3 Filed as: GROUP SUPPLEMENTAL BENEFITS, INC | 31805 TEMECULA PARKWY #288 TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $442 | $3K | 2.83% |
| MICHELLE ANN REESE3 | 9000 SPRING RD COLTON, CA 92324 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $717 | $11 | $728 | 0.67% |
| JANE CONKLIN MILLER3 | 8566 FALLBROOK CIRCLE HUNTINGTON BEACH, CA 92646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.10% |
| JOHN CURTIS RICHERT3 | 183 SAWGRASS LN CALIMESA, CA 92320 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $25 | $77 | 0.07% |
| DEATRA CLINTON JR3 | 1214 S TAMARIND AVE COMPTON, CA 90220 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $47 | $74 | 0.07% |
| ADVANCED BENEFIT CENTER, INC.3 Filed as: ADVANCED BENEFIT CENTER INC | 16145 WHITTIER BLVD WHITTIER, CA 90603 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 0.06% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WILLIAM BROWN | 32997 CASALA CT TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.05% |
| ERIC TERRAZAS3 | 217 LOIS ST LA HABRA, CA 90631 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.03% |
| SANDRA MARIE MARINELLI3 | 26520 KEISSEL ROAD COLTON, CA 92324 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| BOB BLAKE & ASSOCIATES INC3 | BOB BLAKE AND ASSOCIATES LONG BEACH, CA 90802 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| ANDRE CRENSHAW3 | 19605 TALISMAN STREET TORRANCE, CA 90503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| LISA ANN DIMON3 | C/O LISA ANN DIMON GRASS VALLEY, CA 95945 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| SAN BERNADINO PUBLIC INSURANCE SERV3 | 433 N SIERRA WAY SAN BERNADINO, CA 92410 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CYNTHIA L. MOHON4 | 15 N. MICHIGAN ST. REDLANDS, CA 92373 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $321 | — | $321 | 5.78% |
| DEBRA OTTEN4 Filed as: DEBRA L. OTTEN | 123 BRISTOL LN. MAPLES, FL 34112 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $156 | — | $156 | 2.81% |
| PAM MROZ4 | 6770 BRADFORD CT CHINO, CA 91710 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $37 | — | $37 | 0.67% |
| NANCY O. LEWIS4 | 2387 GRACE ST. RIVERSIDE, CA 92504 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $28 | — | $28 | 0.50% |
| NONE | — | STANDARD INSURANCE COMPANY | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OCEA EIN 33-0660405 PARTY IN INTEREST | Direct payment from the plan; Contract Administrator Service code 13 | — | $792K |
| DELTA DENTAL EIN 94-1461312 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $366K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $161K |
| DIMARTINO ASSOCIATES EIN 91-0378940 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $105K |
| VAVRINEK, TRINE, DAY & CO., LLP EIN 95-2648289 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $20K |
| HIGHLAND CAPITAL ADVISORS LLC EIN 20-4284376 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $15K |
| CHARLES SCHWAB & CO., INC. EIN 94-1737782 NONE | Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $0 |
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 | 11,451 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,449 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,900 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 12,597 | $2.3M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 21,785 | $1.6M |
| Short-term disability | STANDARD INSURANCE COMPANY | 12,430 | $799K |
| Long-term disability(2 contracts) | STANDARD INSURANCE COMPANY | 13,497 | $2.0M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 78 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,785 | — |
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.