| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRAY, LESLIE3 | 8583 IRVINE CENTER DIRVE, SUITE 155 IRVINE, CA 92618 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $63K | $5K | $67K | 2.44% |
| TOGNOLI, MARIA3 | 1133 CAMELBACK, 9043 NEWPORT BEACH, CA 92658 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $63K | — | $63K | 2.27% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVC LLC | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | — | $37K | $37K | 1.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER, #300 ORANGE, CA 92868 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | — | $12K | $12K | 0.43% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | — | $3K | $3K | 0.10% |
| LESLIE GRAY3 | 8583 IRVINE CENTER DRIVE, SUITE 155 IRVINE, CA 926184298 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 4.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS. ADMINISTRATORS | 721 S. PARKER STREET, SUITE 300 ORANGE, CA 928684732 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 1.93% |
| LESLIE D GRAY3 | 8583 IRVINE CENTER DIRVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 6.64% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $172 | $2K | $2K | 4.43% |
| LESLIE D GRAY3 | 8583 IRVINE CENTER DIRVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.30% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NC 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $70 | $1K | $1K | 4.20% |
| LESLIE D GRAY3 Filed as: LESLIE D. GRAY | 8583 IRVINE CENTER DIRVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.44% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $135 | $961 | $1K | 4.30% |
| LESLIE D GRAY3 | 8583 IRVINE CENTER DRIVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 22.31% |
| BRITE BENEFITS INC3 Filed as: BRITE BENEFITS INC. | 4270 S CAMILLE STREET HOLLADAY, UT 84124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $118 | — | $118 | 0.69% |
| LESLIE D GRAY3 | 8583 IRVINE CENTER DRIVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 22.31% |
| BRITE BENEFITS INC3 Filed as: BRITE BENEFITS INC. | 4270 S CAMILLE STREET HOLLADAY, UT 84124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $112 | — | $112 | 0.69% |
| LESLIE D GRAY3 | 8583 IRVINE CENTER DRIVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 22.31% |
| BRITE BENEFITS INC3 Filed as: BRITE BENEFITS INC. | 4270 S. CAMILLE STREET HOLLADAY, UT 84124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $66 | — | $66 | 0.69% |
| LESLIE D GRAY3 | 8583 IRVINE CENTER DIRVE, SUITE 155 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $147 | — | $147 | 6.55% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10 | $88 | $98 | 4.37% |
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 | 446 | 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) | 446 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 328 | $3.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 328 | $2.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 328 | $2.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 649 | $25K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 77 | $35K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 446 | $44K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 328 | $3.1M |
| Other(5 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 649 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 649 | — |
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.