| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | BLUE CROSS OF CALIFORNIA | $44K | — | $44K | 5.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21011 WARNER CENTER LANE WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 2.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21011 WARNER CENTER LANE WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $26 | $4K | 13.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $352 | $352 | 1.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | SCANLON GUERRA BURKE INSURANCE WOODLAND HILLS, CA 91365 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $15 | $3K | 9.50% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $881 | $484 | $1K | 5.12% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $463 | $33 | $496 | 1.86% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $343 | $81 | $424 | 1.59% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $259 | $26 | $285 | 1.07% |
| MJ INSURANCE3 Filed as: MARY CIARAVINO AND VARIOUS AGENTS | 1420 PASEO MARLENA AVENUE SAN DIMAS, CA 91773 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $103 | $8 | $111 | 0.42% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21011 WARNER CENTER LANE WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $897 | — | $897 | 6.61% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 254 | $942K |
| Vision | VISION SERVICE PLAN | 93 | $14K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $29K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 254 | $942K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.