| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $91K | $0 | $91K | 4.72% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | BLUE CROSS OF CALIFORNIA | $8K | $0 | $8K | 0.43% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $2K | $12K | 6.72% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $1K | $8K | 4.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS. SVCS. LLC AND OTHER AGENTS | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $337 | $5K | 2.81% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR STREET LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $661 | $3K | 1.90% |
| TECH COORDINATOR CYBER INSURANCE SO3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $456 | $3K | 1.87% |
| LAMBERT MONTALBO3 | 26197 MIRADA STREET HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $69 | $2K | 1.32% |
| GOLD RIVER FINANCIAL GROUP LLC3 Filed as: GOLD RIVER FINANCIAL GROUP, LLC | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $131 | $2K | 0.98% |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 317 | $1.9M |
| Dental | BLUE CROSS OF CALIFORNIA | 317 | $1.9M |
| Vision | BLUE CROSS OF CALIFORNIA | 317 | $1.9M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 317 | $2.1M |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 149 | $181K |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 317 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.