| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVCO INSURANCE SERVICES INC3 Filed as: EVCO INSURANCE SERVICES I | — | CALIFORNIACHOICE | $92K | — | $92K | 5.04% |
| EVCO INSURANCE SERVICES INC3 Filed as: EVCO INS SERVICES INC | 1212 BROADWAY PLZ STE 2100 WALNUT CREEK, CA 945965129 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 9.69% |
| AMWINS3 Filed as: LISI LLC D/B/A AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 5.17% |
| DANIEL J BAZIS3 | 3190 OAK RD WALNUT CREEK, CA 94597 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 15.03% |
| EVCO INSURANCE SERVICES INC3 | 1212 BROADWAY PLAZA WALNUT CREEK, CA 94596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 13.20% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $551 | $2K | $2K | 8.11% |
| STEPHANIE NOELLE KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $660 | $329 | $989 | 3.34% |
| BRITTANY LLOYD3 | PO BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $423 | $463 | $886 | 2.99% |
| BRIAN ROBERT LLOYD3 | 3053 COPPERWOOD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | $540 | $748 | 2.53% |
| MARY KOCH3 | 117 WOLF RIVER CT ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.11% |
| EVCO INSURANCE SERVICES INC3 Filed as: EVCO INS SERVICES INC | 1212 BROADWAY PLZ STE 2100 WALNUT CREEK, CA 945965129 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $807 | — | $807 | 10.00% |
| AMWINS3 Filed as: LISI LLC D/B/A AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $404 | — | $404 | 5.00% |
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 | 378 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 24 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 189 | $1.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 537 | $159K |
| Vision(2 contracts, 2 carriers) | CALIFORNIACHOICE | 537 | $2.0M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 537 | $151K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 53 | $30K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 537 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 537 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.