| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BOULEVARD, SUITE 305 ROCKLIN, CA 95765 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 9.69% |
| PAMELA KAY LONG3 | 200 SOUTH LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $98 | $1K | 2.36% |
| ONE SOURCE ADVISORS INC3 Filed as: ONE SOURCE ADVISORS, LLC | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 2.34% |
| DARRYL W VIDOR3 Filed as: DARRYL W. VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $262 | $0 | $262 | 0.47% |
| JOSEPHINE EBALO BACCAY3 | 3812 AETNA SPRINGS WAY SACRAMENTO, CA 95834 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $43 | $1 | $44 | 0.08% |
| HEALTH MANAGEMENT OPTIONS, INC.3 | 2401A WATERMAN BOULEVARD FAIRFIELD, CA 94534 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.02% |
| BRITTANY LLOYD3 Filed as: BRITTANY LLOYD AND OTHER AGENTS | PO BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 12.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $285 | $285 | 1.02% |
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 | 345 | 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) | 345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 50 | $55K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 257 | $83K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 257 | $83K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 257 | $28K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 257 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.