| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OPTIMA HEALTH PLAN | $15K | $0 | $15K | 2.00% |
| NONSTOP ADMINISTRATION & INSURANCE3 Filed as: NONSTOP ADMINISTRATION & INS. SVCS. | 1800 SUTTER STREET, SUITE 730 CONCORD, CA 94520 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 7.91% |
| BRUCE WAYNE HEAD3 | 700 MONTAUK LANE, SUITE 106 CHESAPEAKE, VA 23320 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 6.93% |
| SUSIE A ESTRADA3 Filed as: SUSIE A. ESTRADA | 25742 PARK AVENUE SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 5.39% |
| G SCOTT COOKE3 Filed as: SCOTT C. CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.68% |
| RALPH F REA JR3 Filed as: RALPH F. REA JR | 84 VIA BARCELONA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.41% |
| NATOSIA VENUS MCNAIR3 | 9005 DANWOOD MANOR TERRACE RICHMOND, VA 23227 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $735 | $172 | $907 | 1.25% |
| MJ INSURANCE3 Filed as: GREGORY A. MOORE & VARIOUS AGENTS | 14 DEODAR IRVINE, CA 92604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $530 | $3 | $533 | 0.73% |
| NONSTOP ADMINISTRATION & INSURANCE3 Filed as: NONSTOP ADMINISTRATION & INS. SVCS. | 1800 SUTTER STREET, SUITE 730 CONCORD, CA 94520 | DELTA DENTAL OF VIRGINIA | $3K | $0 | $3K | 5.01% |
| NONSTOP ADMINISTRATION & INSURANCE3 Filed as: NONSTOP ADMINISTRATION & INS. SVCS. | 1800 SUTTER STREET, SUITE 730 CONCORD, CA 94520 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.00% |
| SCOTT CASTEEL3 | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.50% |
| SUSIE A ESTRADA3 Filed as: SUSIE ANN ESTRADA | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.50% |
| NONSTOP ADMINISTRATION & INSURANCE3 Filed as: NONSTOP ADMINISTRATION & INS. SVCS. | 1800 SUTTER STREET, SUITE 730 CONCORD, CA 94520 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $757 | $0 | $757 | 9.74% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OPTIMA HEALTH PLAN | 139 | $762K |
| Dental | DELTA DENTAL OF VIRGINIA | 140 | $56K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 118 | $8K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 104 | $115K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 46 | $73K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $42K |
| Prescription drug | OPTIMA HEALTH PLAN | 139 | $762K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 104 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.