| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDREINI AND COMPANY3 | 220 WEST TWENTIETH AVENUE SAN MATEO, CA 94403 | PREMIER ACCESS INSURANCE COMPANY | $4K | $0 | $4K | 5.26% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $455 | $2K | 9.74% |
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION INSURANCE SERVICES INC. | 80 SOUTH LAKE AVENUE, SUITE 600 PASADENA, CA 91101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 7.02% |
| WAYNE RIMMER3 Filed as: WAYNE P. SMITH | 1113 WEST GROVE WAY COEUR D ALENE, ID 83815 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 6.00% |
| BRIAN ROBERT LLOYD3 Filed as: BRIAN ROBERT LLOYD AND OTHER AGENTS | 1781 VINEYARD DRIVE, SUITE 225 ANTIOCH, CA 94509 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $461 | $885 | $1K | 5.70% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 5.24% |
| CANDICE ELISE EUSEBIO3 | 5756 OWENS DRIVE APARTMENT 205 PLEASANTON, CA 94588 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $751 | $249 | $1K | 4.23% |
| ANDREINI AND COMPANY3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $569 | $0 | $569 | 2.41% |
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 | 136 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMIER ACCESS INSURANCE COMPANY | 244 | $85K |
| Vision | PREMIER ACCESS INSURANCE COMPANY | 244 | $85K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 65 | $24K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 65 | $24K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 65 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.