| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 100 TUSTIN, CA 927806962 | UNITED HEALTHCARE INSURANCE COMPANY | $27K | — | $27K | 5.61% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 927806962 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 11.15% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N. MAIN STREET, SUITE 800 SANTA ANA, CA 927056687 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.02% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 30.00% |
| JB CREATIVE SOLUTIONS LLC3 | 3881 FREEMAN WAY PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $319 | $2K | 28.61% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $526 | — | $526 | 8.25% |
| MICHAEL F FAHEY III3 | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $239 | $10 | $249 | 3.91% |
| JB CREATIVE SOLUTIONS LLC3 | 3881 FREEMAN WAY PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $3 | $24 | 15.38% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 7.69% |
| MICHAEL F FAHEY III3 | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 2.56% |
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 | 109 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 101 | $483K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 118 | $89K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 118 | $89K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 118 | $96K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 8 | $7K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 101 | $483K |
| Other(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 116 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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.