| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CALIFORNIA INS | 1425 RIVER PARK SACRAMENTO, CA 95815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $885 | — | $885 | 8.76% |
| CUSTOM INSURANCE SPECIALISTS INC3 | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $703 | $18 | $721 | 7.13% |
| JILL HUGHES3 | 6510 TAMARA DRIVE TAYLORSVILLE, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $287 | $24 | $311 | 3.08% |
| DESIREE ROBERTSON3 | 5691 S STONE BLUFF WAY SALT LAKE CITY, UT 84118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.29% |
| PATTI A VINCENT3 | 3489 W 10305 S SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.20% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LN AURORA, IL 60504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
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 | 257 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | LIFEMAP ASSURANCE COMPANY | 168 | $22K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 354 | $43K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 354 | $43K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 354 | $43K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 354 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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.