| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDREINI AND COMPANY3 | 220 WEST TWENTIETH AVENUE SAN MATEO, CA 94403 | PREMIER ACCESS INSURANCE COMPANY | $5K | $0 | $5K | 5.03% |
| ANDREINI AND COMPANY3 | 220 WEST TWENTIETH AVENUE SAN MATEO, CA 94403 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 4.91% |
| LYNN MENDOZA3 Filed as: LYNN MARIE MENDOZA & OTHER AGENTS | 1368 WEST 13TH STREET YUMA, AZ 85364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $228 | $2K | 4.62% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES INC. | 80 SOUTH LAKE AVENUE, SUITE 600 PASADENA, CA 91101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 4.05% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.39% |
| WAYNE RIMMER3 Filed as: WAYNE P. SMITH | 3374 NORTH PARK CROSSING AVENUE MERIDIAN, ID 83646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $936 | $0 | $936 | 1.92% |
| ROSA MURILLO PUENTE3 | 6143 UTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $349 | $93 | $442 | 0.91% |
| SALVADORE HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $320 | $0 | $320 | 0.66% |
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 | 133 | 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) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PREMIER ACCESS INSURANCE COMPANY | 240 | $91K |
| Vision | PREMIER ACCESS INSURANCE COMPANY | 240 | $91K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 59 | $49K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 59 | $49K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 59 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.