| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MILESTONE INSURANCE BROKERS INC.3 | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | BLUE CROSS OF CALIFORNIA | $41K | — | $41K | 2.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. | 721 S. PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $17K | $17K | 1.14% |
| DAVID S JESSE3 Filed as: R DAVID BULEN INSURANCE AGENCY | P.O. BOX 115 LAKE ELSINORE, CA 92531 | BLUE CROSS OF CALIFORNIA | $12K | — | $12K | 0.86% |
| MILESTONE INSURANCE BROKERS INC.3 Filed as: MILESTONE INS BROKERS INC. | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 7.48% |
| DAVID S JESSE3 Filed as: R DAVID BULEN INSURANCE AGENCY | 40750 SYMPHONY PARK LN, STE 101 MURRIETA, CA 92562 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 2.52% |
| MILESTONE INSURANCE BROKERS INC.3 | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 11.15% |
| DAVID S JESSE3 Filed as: R DAVID BULEN INS AGENCY | 40750 SYMPHONY PARK LN, STE 101 MURRIETA, CA 92562 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.05% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS | 9370 SKY PARK CT, STE. 250 SAN DIEGO, CA 92123 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $293 | $16K | 42.70% |
| CARLOS,KARI,LYN3 | 32011 ROSEMARY ST. WINCHESTER, CA 92596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 13.76% |
| MILESTONE INSURANCE BROKERS INC.3 | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.20% |
| ENROLLEASE3 Filed as: ENROLLEASE LLC | 1980 FESTIVAL PLAZA DR., STE. 330 LAS VEGAS, NV 89135 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.99% |
| MILESTONE INSURANCE BROKERS INC.3 | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | CALIFORNIA DENTAL NETWORK, INC. | $2K | — | $2K | 7.89% |
| BULEN & ASSOCIATES INS. SVCS.3 | 40750 SYMPHONY PARK LN, STE 101 MURRIETA, CA 92562 | CALIFORNIA DENTAL NETWORK, INC. | $569 | — | $569 | 2.11% |
| MILESTONE INSURANCE BROKERS INC.3 | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS | 9370 SKY PARK COURT, STE. 250 SAN DIEGO, CA 92123 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $81 | $5K | 35.47% |
| CARLOS,KARI,LYN3 | 32011 ROSEMARY ST. WINCHESTER, CA 92596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 13.82% |
| ENROLLEASE3 Filed as: ENROLLEASE LLC | 1980 FESTIVAL PLAZA DR. STE 330 LAS VEGAS, NV 89135 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $373 | — | $373 | 2.49% |
| MILESTONE INSURANCE BROKERS INC.3 | 8 CORPORATE PARK, SUITE 130 IRVINE, CA 92606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.80% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 407 | $1.4M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 201 | $113K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 397 | $25K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 217 | $42K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 26 | $15K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 407 | $1.4M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 360 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 407 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.