| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MDX FINANCIAL SERVICES, INC.3 Filed as: MDX FINANCIAL & INSURANCE SERVICES | 8175 E BROOKDALE LN ANAHEIM, CA 92807 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $4K | — | $4K | 9.20% |
| MDX FINANCIAL SERVICES, INC.3 | 8175 E BROOKDALE LN ANAHEIM, CA 92807 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| MDX FINANCIAL SERVICES, INC.3 Filed as: MDX FINANCIAL SERVICES | 8175 EAST BROOKDALE LANE ANAHEIM, CA 92807 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| MDX FINANCIAL SERVICES, INC.3 Filed as: MDX FINANCIAL SERVICES | 8175 EAST BROOKDALE LANE ANAHEIM, CA 92807 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 13.80% |
| MDX FINANCIAL SERVICES, INC.3 Filed as: MDX FINANCIAL SERVICES | 8175 EAST BROOKDALE LANE ANAHEIM, CA 92807 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 13.78% |
| MDX FINANCIAL SERVICES, INC.3 | 8175 E BROOKDALE LN ANAHEIM, CA 92807 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $772 | — | $772 | 10.00% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $386 | — | $386 | 5.00% |
| DAVID A. RACKLIFFE3 | 300 HEROIT CT SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $945 | $43 | $988 | 18.97% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E. HAMILTON AVE CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $472 | — | $472 | 9.06% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $443 | $17 | $460 | 8.83% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $79 | — | $79 | 6.49% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 2824 SAINT ANDREWS RD FAIRFIELD, CA 94534 | AFLAC | $20 | — | $20 | 1.64% |
| KENNETH FRANCIS O'ROURKE3 | P.O. BOX 1375 PLACENTIA, CA 92871 | AFLAC | $16 | — | $16 | 1.31% |
| DAVID A. BJORKLUND3 | 11 CALLE VECINO SAN CLEMENTE, CA 92673 | AFLAC | $12 | — | $12 | 0.99% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT W. BLACKSHEAR | 108 ALSACE CT PONTE VERDA BEACH, FL 32082 | AFLAC | $6 | — | $6 | 0.49% |
| CHRIS BRANSON3 | PO BOX 930 MAKAWAO, HI 96768 | AFLAC | $3 | — | $3 | 0.25% |
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 | 322 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 517 | $46K |
| Life insurance(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 322 | $54K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 3 | $6K |
| Other(6 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 322 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 517 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.