| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE SERVICES, LLC | 1026 WEST EL NORTE PKWY SUITE 132 ESCONDIDO, CA 92026 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $61K | — | $61K | 2.61% |
| 28 INSURANCE AGENCY3 | PO BOX 696 KINGSBURG, CA 93631 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $13K | — | $13K | 0.56% |
| MODERN REIGN INSURANCE BROKERS3 Filed as: MODERN REIGN INSURANCE BROKERS, LLC | 27762 ANTONIO PKWY, L-1 #473 LADERA RANCH, CA 92694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $7K | — | $7K | 0.31% |
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE SERVICES, LLC | 1026 W EL NORTE PKWY STE 132 ESCONDIDO, CA 920263341 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | — | $15K | 3.75% |
| 28 INSURANCE AGENCY3 | PO BOX 696 KINGSBURG, CA 936310696 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 0.79% |
| MODERN REIGN INSURANCE BROKERS3 Filed as: MODERN REIGN INSURANCE BROKERS, LLC | 27201 PUERTA REAL STE 130 MISSION VIEJO, CA 926918561 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 0.41% |
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE SERVICES, LLC | 140 W 3RD AVE ESCONDIDO, CA 92025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 12.18% |
| 28 INSURANCE AGENCY3 | 1490 DRAPER ST KINGSBURG, CA 93631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.66% |
| MODERN REIGN INSURANCE BROKERS3 Filed as: MODERN REIGN INSURANCE | BROKERS LLC 27201 PUERTA REAL STE 130 MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $605 | — | $605 | 0.80% |
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE SERVICES, LLC | 140 W 3RD AVE ESCONDIDO, CA 92025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 12.31% |
| 28 INSURANCE AGENCY3 | 1490 DRAPER ST KINGSBURG, CA 93631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $453 | — | $453 | 1.71% |
| MODERN REIGN INSURANCE BROKERS3 Filed as: MODERN REIGN INSURANCE | BROKERS LLC 27201 PUERTA REAL STE 130 MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $228 | — | $228 | 0.86% |
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE SERVICES, LLC | 140 W 3RD AVE ESCONDIDO, CA 92025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 12.21% |
| 28 INSURANCE AGENCY3 | 1490 DRAPER ST KINGSBURG, CA 93631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $392 | — | $392 | 1.65% |
| MODERN REIGN INSURANCE BROKERS3 Filed as: MODERN REIGN INSURANCE | BROKERS LLC 27201 PUERTA REAL STE 130 MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $191 | — | $191 | 0.80% |
| TIPPETT MOORHEAD AND HADEN3 Filed as: TIPPETT MOORHEAD & HADEN, | AN ALERA GROUP AGENCY 3200 PARK CENTER DR STE 550 COSTA MESA, CA 92626 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.51% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $469 | $469 | 2.00% |
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE SERVICES, LLC | 140 W 3RD AVE ESCONDIDO, CA 92025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 12.01% |
| 28 INSURANCE AGENCY3 | 1490 DRAPER ST KINGSBURG, CA 93631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $376 | — | $376 | 1.69% |
| MODERN REIGN INSURANCE BROKERS3 Filed as: MODERN REIGN INSURANCE | BROKERS LLC 27201 PUERTA REAL STE 130 MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $178 | — | $178 | 0.80% |
| CULTURE INSURANCE SVCS LLC3 Filed as: CULTURE INSURANCE | SERVICES, LLC 1026 W EL NORTE PKWY STE 132 ESCONDIDO, CA 92026 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 43.09% |
| TIPPETT MOORHEAD AND HADEN3 Filed as: TIPPETT MOORHEAD & HADEN, | AN ALERA GROUP AGENCY 3200 PARK CENTER DR STE 550 COSTA MESA, CA 92626 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $196 | — | $196 | 4.58% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $86 | $86 | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT | SERVICES, INC. STE 200 18201 VON KARMAN AVE IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $81 | — | $81 | 2.82% |
| 28 INSURANCE AGENCY3 | PO BOX 696 KINGSBURG, CA 93631 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | — | $10 | 0.35% |
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 | 220 | 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) | 220 | 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) | 178 | $2.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 178 | $2.3M |
| Vision | EYEMED VISION CARE | 309 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $50K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 65 | $22K |
| Long-term disability(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 231 | $109K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.