| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1745 NORTH BROWN ROAD, SUITE 250 LAWRENCEVILLE, GA 30043 | BLUE CROSS OF CALIFORNIA | $62K | $0 | $62K | 5.81% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $0 | $21K | $21K | 1.94% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | $3K | $25K | 22.93% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $75 | $4K | 8.38% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $804 | $4K | 8.29% |
| TECH COORDINATOR CYBER INSURANCE SO3 Filed as: TECH COORDINATOR CYBER INS. SO. | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $298 | $2K | 3.13% |
| SARAH COURTNEY KNAPP3 Filed as: SARAH C. KNAPP AND OTHER AGENTS | 61 SKLAR STREET LADERA RANCH, CA 92694 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $162 | $1K | 2.80% |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALEZ | 11677 SANDPIPER COURT MORENO VALLEY, CA 92557 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $758 | $139 | $897 | 1.77% |
| KRISTIN ANN DECOU3 | 751 ROBIN GLEN ROAD BEAUMONT, CA 92223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $466 | $23 | $489 | 0.97% |
| RAYMOND KWOCKMAN GONG3 | 1907 COLUMBIA STREET, APARTMENT 501 SAN DIEGO, CA 92101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $400 | $86 | $486 | 0.96% |
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 | 207 | 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) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 165 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $108K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 207 | $1.2M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $108K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 94 | $51K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 165 | $1.1M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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.