| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | KAISER FOUNDATION HEALTH PLAN, INC. | $19K | — | $19K | 5.37% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | — | $9K | 2.53% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREEET SUITE 700 MINNEAPOLIS, MN 55402 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 7.20% |
| FREDRICK D BRADFORD3 Filed as: FREDRICK D. BRADFORD | 16057 OAKLEY ROAD RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 9.61% |
| TAMMY LYNN RANAHAN3 | 26337 ARBORETUM WAY MURRIETA, CA 92563 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $68 | $1K | 4.32% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $603 | $244 | $847 | 2.64% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $515 | $130 | $645 | 2.01% |
| JOHN D EVANGELISTA3 Filed as: JOHN EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $249 | $99 | $348 | 1.09% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $278 | $32 | $310 | 0.97% |
| THOMAS J LANPHIER3 | 14252 CULVER DR IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $298 | — | $298 | 0.93% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND GONG | 2180 FENTON PKWY SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $199 | $62 | $261 | 0.82% |
| BENJAMIN ACEVEDO3 | 16211 E GROVECENTER ST COVINA, CA 91722 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $199 | $19 | $218 | 0.68% |
| BRUCE W BUSSER3 | 22461 SAN JOAQUIN DRIVE WEST CANYON LAKE, CA 92587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $215 | $2 | $217 | 0.68% |
| DAVID C. RADIMAKER3 Filed as: DAVID C RADIMAKER | 434 ALVARADO ST REDLANDS, CA 92373 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | $30 | $129 | 0.40% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INSURANCE ADVOCATES, INC | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $43 | $123 | 0.38% |
| JOSEPH RUBINO3 | 1806 BRABHAM STREET EL CAJON, CA 92019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $5 | $105 | 0.33% |
| GCG FINANCIAL LLC3 Filed as: TERRANCE HUGH DICKERSON | 34400 GLENWOOD DR YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | $6 | $105 | 0.33% |
| WILLIAM L WISER3 | 12725 JARDIN ROAD SAN DIEGO, CA 92128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | $2 | $103 | 0.32% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $31 | $94 | 0.29% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $29 | $51 | 0.16% |
| LUIS ERNESTO PEREZ3 | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $5 | $32 | 0.10% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $4 | $12 | 0.04% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN DOUGLASS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| RICHARD BLACKSTONE3 | 653 VERDANT PLACE VISTA, CA 92084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| LIFE TIME SOLUTIONS LLC3 Filed as: LIFE TIME SOLUTIONS, LLC | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $795 | — | $795 | 7.05% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | CALIFORNIA DENTAL NETWORK, INC. | $1K | — | $1K | 10.47% |
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 | 172 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 85 | $351K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 185 | $47K |
| Vision | VISION SERVICE PLAN | 82 | $11K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 185 | $69K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 35 | $32K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 185 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.