| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $63K | $6K | $69K | 5.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21011 WARNER CENTER LANE WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1 | $2K | 10.61% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $364 | $18 | $382 | 2.60% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $155 | $3 | $158 | 1.08% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $127 | $0 | $127 | 0.87% |
| EDWIN MANUEL VELASQUEZ3 Filed as: EDWIN MANUAL VELASQUEZ | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $101 | $0 | $101 | 0.69% |
| CA INS. ADVOCATES AND VARIOUS AGENT3 Filed as: CA INS. ADVOCATES AND OTHER AGENTS | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $56 | $4 | $60 | 0.41% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.29% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Dental | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Vision | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.