| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL B. KELLY INSURANCE3 | P. O. BOX 222634 CARMEL, CA 939222634 | METROPOLITAN LIFE INSURANCE COMPANY | $50K | — | $50K | 9.90% |
| AMWINS3 Filed as: LISI, LLC | 2677 N MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $1K | $28K | 5.56% |
| MICHAEL B. KELLY INSURANCE3 | P. O. BOX 222634 CARMEL, CA 939222263 | VISION SERVICE PLAN | $2K | — | $2K | 2.93% |
| BRITTANY LLOYD3 | 6234 KINGS PEAK DRIVE EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $6K | $11K | 25.59% |
| MICHAEL B. KELLY INSURANCE3 Filed as: MICHAEL B KELLY INSURANCE SERVICES | PO BOX 222634 CARMEL, CA 93922 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 12.97% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN STREET SANTA ANA, CA 92705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 6.99% |
| STEPHANIE NOELLE KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $710 | $425 | $1K | 2.54% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $538 | $25 | $563 | 1.26% |
| LUIS ERNESTO PEREZ3 Filed as: LUIS PEREZ BENEFIT INSURANCE SOLUTI | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $429 | $84 | $513 | 1.15% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $257 | $78 | $335 | 0.75% |
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 | 456 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 458 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 992 | $506K |
| Vision | VISION SERVICE PLAN | 484 | $77K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 93 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 992 | — |
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.