| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 | 21820 BURBANK BOULEVARD WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $41K | $0 | $41K | 4.99% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 21820 BURBANK BOULEVARD WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $22K | $0 | $22K | 4.99% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 21820 BURBANK BOULEVARD WOODLAND HILLS, CA 91367 | DELTA DENTAL OF CALIFORNIA | $7K | $0 | $7K | 9.99% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 12.04% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $650 | $0 | $650 | 3.11% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $643 | $0 | $643 | 3.07% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $544 | $80 | $624 | 2.98% |
| TECH COORDS CYBER & OTHER AGENTS3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $510 | $16 | $526 | 2.51% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR STREET LADERA RANCH, CA 92694 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $268 | $28 | $296 | 1.41% |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALEZ | 11677 SANDPIPER COURT MORENO VALLEY, CA 92557 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $235 | $36 | $271 | 1.29% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS., INC. | 80 SOUTH 8TH STREET MINNEAPOLIIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $235 | $0 | $235 | 1.12% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 10.14% |
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 | 176 | 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) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 117 | $1.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 96 | $73K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 134 | $13K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 176 | $73K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 176 | $52K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 117 | $1.3M |
| Other(4 contracts, 4 carriers) | AETNA HEALTH, INC. | 176 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.