| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRACEY KEISER3 Filed as: TRACEY KEISER-FRAZIER | 400 S PERALTA HILLS DR ANAHEIM, CA 92807 | BLUE CHOICE HEALTH PLAN | $26K | — | $26K | 5.91% |
| TRACEY KEISER3 Filed as: TRACEY KEISER-FRAZIER | 405 PERALTA HILLS DRIVE ANAHEIM, CA 92807 | THE GUARDIAN LIFE INSURANCE COMPANY | $13K | — | $13K | 3.38% |
| WORXSITEHR INSURANCE SOLUTIONS3 | 23679 CALABASAS RD STE 514 CALABASAS, CA 91302 | THE GUARDIAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.17% |
| TRACEY KEISER3 Filed as: TRACEY KEISER-FRAZIER | 400 S PERALTA HILLS DR ANAHEIM, CA 92807 | RELIASTAR LIFE INSURANCE COMPANY | $40K | — | $40K | 10.68% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS, INC | 23679 CALABASAS RD STE 514 CALABASAS, CA 91302 | RELIASTAR LIFE INSURANCE COMPANY | $35K | — | $35K | 9.36% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS INC | 23679 CALABASAS RD CALABASAS, CA 91302 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | — | $10K | 13.75% |
| TRACEY KEISER3 Filed as: TRACEY KEISER-FRAZIER | 8181 E KAISER BLVD ANAHEIM, CA 92808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 11.25% |
| MICHAEL FREDERICK FIERKE3 | 2631 HOLLY SPRINGS PKWY #391 HOLLY SPRINGS, GA 30142 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 20.58% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS INC | 23679 CALABASAS RD STE 514 CALABASAS, CA 91302 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 10.30% |
| MICHAEL FREDERICK FIERKE3 | 2631 HOLLY SPRINGS PKWY #391 HOLLY SPRINGS, GA 30142 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 28.02% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS INC | 23679 CALABASAS RD STE 514 CALABASAS, CA 91302 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 2.74% |
| TRACEY KEISER3 Filed as: TRACEY KEISER-FRAZIER | 8181 E KAISER BLVD ANAHEIM, CA 92808 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 26.82% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS INC | 23679 CALABASAS RD CALABASAS, CA 91302 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | -$405 | — | -$405 | -1.82% |
| MICHAEL FREDERICK FIERKE3 | 2631 HOLLY SPRINGS PKWY #391 HOLLY SPRINGS, GA 30142 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 30.87% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS INC | 23679 CALABASAS RD STE 514 CALABASAS, CA 91302 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $170 | — | $170 | 1.33% |
| DONALD B FAULKNER SR3 | 612 IVY GREEN LANE IRMO, SC 29063 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $590 | $19 | $609 | 13.05% |
| TERRY J SILVERS3 Filed as: TERRY D GARRETT | 459 RUNNING FOX RD WEST COLUMBIA, SC 29223 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $59 | — | $59 | 1.26% |
| ADVANCED BENEFIT SYSTEM INC3 | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $29 | $27 | $56 | 1.20% |
| SHERRON HOPPER3 | P.O. BOX 85206 LEXINGTON, SC 29073 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $43 | — | $43 | 0.92% |
| CHARLES BOND3 | 749 PIKE ROAD PIKE ROAD, AL 36064 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $39 | — | $39 | 0.84% |
| KATIE H JOHNSON3 | 1106 GRANDVIEW DR KIRKWOOD, MO 63122 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $7 | — | $7 | 0.15% |
| SANDRA J RUNION3 | 104 SIR EDWARDS LANE LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT LIFE INSURANCE COMPANY | $7 | — | $7 | 0.15% |
| MICHAEL FREDERICK FIERKE3 | 2631 HOLLY SPRINGS PKWY #391 HOLLY SPRINGS, GA 30142 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $758 | — | $758 | 20.73% |
| WORXSITEHR INSURANCE SOLUTIONS3 Filed as: WORXSITEHR INSURANCE SOLUTIONS INC | 23679 CALABASAS RD STE 514 CALABASAS, CA 91302 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $324 | — | $324 | 8.86% |
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 | 12,842 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 12,845 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | BLUE CHOICE HEALTH PLAN | 585 | $536K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 804 | $378K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,054 | $71K |
| Life insurance(5 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 13,956 | $473K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 13,956 | $375K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 26 | $22K |
| Other(4 contracts, 4 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 13,956 | $595K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,956 | — |
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.