| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AETNA HEALTH OF CALIFORNIA INC. | $93K | $15K | $108K | 5.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY | $41K | — | $41K | 6.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2345 GRAND AVENUE, SUITE 400 KANSAS CITY, MO 64108 | AETNA LIFE INSURANCE COMPANY | — | $113 | $113 | 0.02% |
| MJ INSURANCE3 Filed as: BENEFITS COORD. AND VARIOUS AGENTS | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17K | $3K | $20K | 11.39% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $3K | $16K | 8.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $482 | $13K | 7.12% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $2K | $9K | 5.26% |
| LIFE TIME SOLUTIONS LLC3 Filed as: LIFE TIME SOLUTIONS, LLC | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $833 | $4K | 2.26% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 2.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 92503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 1.89% |
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 | 451 | 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) | 451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 648 | $2.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 648 | $651K |
| Vision | AETNA LIFE INSURANCE COMPANY | 648 | $651K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 648 | $651K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 648 | $651K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 648 | $2.7M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 648 | $846K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 648 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.