| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NELLA INSURANCE SERVICES3 | 15233 VENTURA BOULEVARD, SUITE 1308 SHERMAN OAKS, CA 91403 | CALIFORNIACHOICE | $44K | $0 | $44K | 5.00% |
| KIMLAI JONES3 | 2277 WEST 23RD STREET LOS ANGELES, CA 90018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $775 | $12K | 9.07% |
| KEYSHA LATRICE GWIN3 Filed as: KEYSHA GWIN | 1357 SOUTH STANLEY AVENUE LOS ANGELES, CA 90019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $1K | $12K | 8.99% |
| SUSAN GOLD STOKES3 Filed as: SUSAN STOKES | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $681 | $5K | 3.34% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $988 | $3K | 2.42% |
| SD LANGHOME INSURANCE SERVICES3 | 10560 NATIONAL BOULEVARD, SUITE 3 LOS ANGELES, CA 90034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $490 | $2K | 1.58% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INS. SVCS. AND OTHER AGENTS | 2300 CONTRA COSTA BOULEVARD SUITE 600 PLEASANT HILL, CA 94523 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $34 | $1K | 0.97% |
| ROSE VILLALON PASQUEL3 Filed as: ROSE PASQUEL | 552 EAST CARSON STREET SUITE 104-412 CARSON, CA 90745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $916 | $25 | $941 | 0.69% |
| KIMLAI JONES3 | 2277 WEST 23RD STREET LOS ANGELES, CA 90018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $285 | $6K | 8.43% |
| KEYSHA LATRICE GWIN3 Filed as: KEYSHA GWIN | 1357 SOUTH STANLEY AVENUE LOS ANGELES, CA 90019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $569 | $5K | 7.31% |
| SUSAN GOLD STOKES3 Filed as: SUSAN STOKES | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $338 | $2K | 3.34% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $434 | $2K | 2.24% |
| SD LANGHOME INSURANCE SERVICES3 | 10560 NATIONAL BOULEVARD, SUITE 3 LOS ANGELES, CA 90034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $980 | $280 | $1K | 1.85% |
| MJ INSURANCE3 Filed as: ROSE PASQUEL AND VARIOUS AGENTS | 552 EAST CARSON STREET SUITE 104-412 CARSON, CA 90745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $720 | $122 | $842 | 1.23% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC | 2300 CONTRA COSTA BOULEVARD SUITE 600 PLEASANT HILL, CA 94523 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $378 | $0 | $378 | 0.55% |
| KIMLAI JONES3 | 2277 WEST 23RD STREET LOS ANGELES, CA 90018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $103 | $3K | 9.43% |
| KEYSHA LATRICE GWIN3 Filed as: KEYSHA GWIN | 1357 SOUTH STANLEY AVENUE LOS ANGELES, CA 90019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $204 | $2K | 6.68% |
| SUSAN GOLD STOKES3 Filed as: SUSAN STOKES | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $597 | $103 | $700 | 2.48% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $392 | $140 | $532 | 1.88% |
| SD LANGHOME INSURANCE SERVICES3 | 10560 NATIONAL BOULEVARD, SUITE 3 LOS ANGELES, CA 90034 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $203 | $35 | $238 | 0.84% |
| MJ INSURANCE3 Filed as: MAIRA ORTIZ AND VARIOUS AGENTS | 43642 35TH STREET EAST LANCASTER, CA 93535 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $201 | $3 | $204 | 0.72% |
| ROSE VILLALON PASQUEL3 Filed as: ROSE PASQUEL | 552 EAST CARSON STREET SUITE 104-412 CARSON, CA 90745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $146 | $4 | $150 | 0.53% |
| NELLA INSURANCE SERVICES3 | 15233 VENTURA BOULEVARD, SUITE 1308 SHERMAN OAKS, CA 91403 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $685 | $0 | $685 | 5.84% |
| NELLA INSURANCE SERVICES3 | 21031 VENTURA BOULEVARD, SUITE 512 WOODLAND HILLS, CA 91364 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $488 | $0 | $488 | 4.16% |
| NELLA INSURANCE SERVICES3 | 21031 VENTURA BOULEVARD, SUITE 512 WOODLAND HILLS, CA 91364 | DENTAL HEALTH SERVICES | $1K | $0 | $1K | 10.01% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 113 | $877K |
| Dental | DENTAL HEALTH SERVICES | 89 | $11K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 154 | $12K |
| Life insurance(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 125 | $233K |
| Other(3 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 125 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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.