| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILL INSURANCE SERVICES LLC3 Filed as: HILL INSURANCE SERVICES | 14350 N. 87TH STREET, SUITE 115 SCOTTSDALE, AZ 85260 | PREMIER ACCESS INSURANCE COMPANY | $42K | — | $42K | 7.98% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY, SUITE 400 RANCHO SANTA MARGARITA, CA 92688 | PREMIER ACCESS INSURANCE COMPANY | $23K | — | $23K | 4.36% |
| VARIOUS - SEE ATTACHED3 | C/O COLONIAL LIFE P.O. BOX 1365 COLUNBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $78 | $12K | 18.55% |
| HILL INSURANCE SERVICES LLC3 | 14350 N. 87TH STREET, SUITE 115 SCOTTSDALE, AZ 85260 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.10% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $45 | $137 | 0.22% |
| BENEFIT COORDINATOR3 | P.O. BOX 727 ARTESIA, CA 92702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $24 | $116 | 0.19% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $16 | $108 | 0.18% |
| ELIZABETH J DOWNEY3 Filed as: ELIZABETH J. DOWNEY | 2883 OAKWOOD DRIVE PORT HURON, MI 48060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.11% |
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 | 458 | 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) | 459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMIER ACCESS INSURANCE COMPANY | 441 | $523K |
| Vision | PREMIER ACCESS INSURANCE COMPANY | 441 | $523K |
| Life insurance(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 458 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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.