| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | BLUE CROSS OF CALIFORNIA | $49K | $0 | $49K | 5.90% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES, LLC | 1600 WEST HILLSDALE BOULEVARD, SUIT SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | $0 | $16K | $16K | 1.97% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY, INC. | 1787 SENTRY PARKWAY WEST VEVA BUILDING 16, SUITE 320 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | $3K | $21K | 23.62% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 13.84% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $125 | $5K | 10.41% |
| TECH COORDINATOR CYBER INSURANCE SO3 Filed as: TECH COORDINATOR CYBER INS. SOLUTIO | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $527 | $2K | 4.39% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND K. GONG AND OTHER AGENTS | 1907 COLUMBIA STREET SAN DIEGO, CA 92101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $885 | $146 | $1K | 2.22% |
| KRISTIN ANN DECOU3 | 751 ROBIN GLEN ROAD BEAUMONT, CA 92223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $728 | $231 | $959 | 2.06% |
| SUMMIT FINANCIAL GROUP INC.3 Filed as: SUMMIT BENEFIT SOLUTIONS, INC. | 12223 HIGHLAND AVENUE RANCHO CUCAMONGA, CA 91739 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $614 | $14 | $628 | 1.35% |
| GOLD RIVER FINANCIAL GROUP LLC3 Filed as: GOLD RIVER FINANCIAL GROUP, LLC | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $511 | $92 | $603 | 1.30% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 145 | $830K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 161 | $90K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 161 | $920K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 161 | $90K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 89 | $46K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 145 | $830K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 161 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.