| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | BLUE CROSS OF CALIFORNIA | $146K | $2K | $147K | 2.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN., INC. | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $0 | $113K | $113K | 2.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $96K | $0 | $96K | 1.74% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | BLUE CROSS OF CALIFORNIA | $0 | $3K | $3K | 0.06% |
| INTEGRITY FIRST BUSINESS SOLUTIONS3 | 904 CUTTING HORSE DRIVE MANSFIELD, TX 76063 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | $0 | $12K | 4.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $0 | $8K | 3.09% |
| ARYEHA L. AUGUSTIN FLETCHER3 | 3033 BARDIN ROAD, SUITE 819 GRAND PRAIRIE, TX 75052 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $4K | $9K | 14.57% |
| INTEGRITY FIRST BUSINESS SOLUTIONS3 | 2801 OSLER DRIVE, SUITE 122 GRAND PRAIRIE, TX 75051 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 8.74% |
| AYA MAHMOUD-HINDI AND OTHER AGENTS3 | 2820 HUDSON BOULEVARD COLONY, TX 75056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 7.02% |
| 3B VENTURE GROUP INC3 Filed as: 3B VENTURE GROUP OF TEXAS, INC. | 832 MALLARD TRAIL MURPHY, TX 75094 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 6.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $308 | $3K | 5.51% |
| GOLD RIVER FINANCIAL GROUP LLC3 Filed as: GOLD RIVER FINANCIAL GROUP, LLC | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $260 | $3K | 4.38% |
| JENNIFER E LUBELSKY3 Filed as: JENNIFER E. LUBELSKY | 80 JOHN STREET, APARTMENT 11C NEW YORK, NY 10038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $285 | $2K | 3.62% |
| ARYEHA L. AUGUSTIN FLETCHER3 | 3033 BARDIN ROAD, SUITE 819 GRAND PRAIRIE, TX 75052 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 14.91% |
| INTEGRITY FIRST BUSINESS SOLUTIONS3 | 2801 OSLER DRIVE, SUITE 122 GRAND PRAIRIE, TX 75051 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $639 | $2K | 10.07% |
| AYA MAHMOUD-HINDI AND OTHER AGENTS3 | 2820 HUDSON BOULEVARD COLONY, TX 75056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $996 | $287 | $1K | 7.17% |
| JENNIFER E LUBELSKY3 Filed as: JENNIFER E. LUBELSKY | 80 JOHN STREET, APARTMENT 11C NEW YORK, NY 10038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $853 | $132 | $985 | 5.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $810 | $85 | $895 | 5.00% |
| 3B VENTURE GROUP INC3 Filed as: 3B VENTURE GROUP OF TEXAS, INC. | 832 MALLARD TRAIL MURPHY, TX 75094 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $433 | $446 | $879 | 4.91% |
| PETER DEL INVESTMENTS INC3 Filed as: PETER DEL INVESTMENTS, INC. | 247 GRAHAM FORNEY, TX 75126 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $521 | $205 | $726 | 4.06% |
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 | 520 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 523 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 729 | $5.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 729 | $5.5M |
| Vision | BLUE CROSS OF CALIFORNIA | 729 | $5.5M |
| Life insurance(2 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 135 | $77K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 145 | $256K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 145 | $256K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 729 | $5.5M |
| Other(2 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 135 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 729 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.