| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | HEALTH NET | $45K | $1K | $46K | 5.08% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2000 ALAMEDA DE LAS PULGAS SAN MATEO, CA 94403 | BLUE CROSS BLUE SHIELD OF ARIZONA | $40K | — | $40K | 4.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 8.91% |
| INTEGRO INSURANCE BROKERS3 Filed as: EPIC INSURANCE BROKERS & | CONSULTANTS 12009 FOUNDATION PLACE, SUITE 370 GOLD RIVER, CA 95670 | ARMADACARE | $2K | — | $2K | 1.06% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BLVD. PH FLOOR IRVINE, CA 92612 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.86% |
| STERN INSURANCE GROUP INC3 Filed as: STERN INSURANCE GROUP, INC | 11445 EAST VIA LINDA NO 2611 SCOTTSDALE, AZ 85259 | TRANSAMERICA LIFE INSURANCE COMPANY | $712 | — | $712 | 3.87% |
| CINDY L SANTANGELO3 Filed as: CINDY SANTANGELO | 3757 ARCHETTO DR. EL DORADO HILLS, CA 95762 | TRANSAMERICA LIFE INSURANCE COMPANY | $328 | — | $328 | 1.78% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 E DOUBLETREE RANCH RD STE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $138 | — | $138 | 0.75% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $379 | $20 | $399 | 2.76% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $295 | $2 | $297 | 2.05% |
| HELEN R GIROUX3 | 10061 RIVERSIDE DR. TOLUCA LAKE, CA 91602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $276 | — | $276 | 1.91% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 9795 GATEWAY DR RENO, NV 89521 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $145 | — | $145 | 1.00% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $27 | $136 | 0.94% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DR MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 0.59% |
| LIFE TIME SOLUTIONS LLC3 | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.58% |
| KEVIN FITZGERALD HOWARD3 | PO BOX 30024 OAKLAND, CA 94604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.20% |
| HURTADO & ASSOCIATES LLC3 | 11309 BORSON ST NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.16% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON ST FILLMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $1 | $23 | 0.16% |
| SHANE G ROSS3 | 620 E CABERNET COURT UPLAND, CA 91786 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.09% |
| SUSAN GOLD STOKES3 | 17042 PINEHURST LN #D HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| PATRICIA FERNANDEZ3 | 4949 N 7TH ST PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| NOEL HASERT3 | 5104 E AZALEA CIR SIOUX FALLS, SD 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
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 | 233 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTH NET | 101 | $1.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $180K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $180K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $195K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 16 | $14K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 101 | $807K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.