| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NELLA INSURANCE SERVICES3 | 15233 VENTURA BOULEVARD, SUITE 1308 SHERMAN OAKS, CA 91403 | CALIFORNIACHOICE | $35K | $0 | $35K | 4.99% |
| KEYSHA LATRICE GWIN3 Filed as: KEYSHA GWIN | 13757 SOUTH STANLEY DRIVE LOS ANGELES, CA 90019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15K | $4K | $19K | 11.80% |
| KIMLAI JONES3 | 2277 WEST 23RD STREET LOS ANGELES, CA 90018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $0 | $14K | 8.47% |
| SD LANGHOME INSURANCE SERVICES3 | 10560 NATIONAL BOULEVARD, SUITE 3 LOS ANGELES, CA 90034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $2K | $12K | 7.22% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 3.12% |
| MJ INSURANCE3 Filed as: SUSAN STOKES AND VARIOUS AGENTS | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $201 | $2K | 1.30% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | 2300 CONTRA COSTA BOULEVARD SUITE 600 PLEASANT HILL, CA 94523 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $715 | $0 | $715 | 0.44% |
| MAIRA MAGALI ORTIZ3 Filed as: MAIRA ORTIZ | 43642 35TH STREET EAST LANCASTER, CA 93535 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $565 | $0 | $565 | 0.35% |
| KEYSHA LATRICE GWIN3 Filed as: KEYSHA GWIN | 13757 SOUTH STANLEY DRIVE LOS ANGELES, CA 90019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 13.01% |
| SD LANGHOME INSURANCE SERVICES3 | 10560 NATIONAL BOULEVARD, SUITE 3 LOS ANGELES, CA 90034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $969 | $5K | 9.29% |
| KIMLAI JONES3 | 2277 WEST 23RD STREET LOS ANGELES, CA 90018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 8.35% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $736 | $2K | 3.59% |
| MJ INSURANCE3 Filed as: MCCAREY INC AND VARIOUS AGENTS | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $228 | $59 | $287 | 0.49% |
| SUSAN GOLD STOKES3 Filed as: SUSAN STOKES | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $181 | $36 | $217 | 0.37% |
| ASSUREDPARTNERS3 Filed as: BERTHA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $157 | $33 | $190 | 0.33% |
| KEYSHA LATRICE GWIN3 Filed as: KEYSHA GWIN | 13757 SOUTH STANLEY DRIVE LOS ANGELES, CA 90019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $482 | $2K | 10.17% |
| KIMLAI JONES3 | 2277 WEST 23RD STREET LOS ANGELES, CA 90018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 7.57% |
| SD LANGHOME INSURANCE SERVICES3 | 10560 NATIONAL BOULEVARD, SUITE 3 LOS ANGELES, CA 90034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $807 | $178 | $985 | 4.85% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $362 | $177 | $539 | 2.65% |
| MJ INSURANCE3 Filed as: SUSAN STOKES AND VARIOUS AGENTS | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $199 | $20 | $219 | 1.08% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES | 2300 CONTRA COSTA BOULEVARD SUITE 600 PLEASANT HILL, CA 94523 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $191 | $0 | $191 | 0.94% |
| ASHLEY ROCHELLE MARK3 Filed as: ASHLEY MARK | 1951 WEST 95TH STREET LOS ANGELES, CA 90047 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $177 | $0 | $177 | 0.87% |
| NELLA INSURANCE SERVICES3 | 21031 VENTURA BOULEVARD, SUITE 512 WOODLAND HILLS, CA 91364 | DENTAL HEALTH SERVICES | $613 | $0 | $613 | 10.04% |
| NELLA INSURANCE SERVICES3 | 15233 VENTURA BOULEVARD, SUITE 1308 SHERMAN OAKS, CA 91403 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $641 | $0 | $641 | 11.34% |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 104 | $708K |
| Dental | DENTAL HEALTH SERVICES | 60 | $6K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 90 | $6K |
| Life insurance(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 89 | $239K |
| Other(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 89 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.