| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | CALIFORNIA PHYSICIANS SERVICE | $92K | — | $92K | 4.23% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | $0 | $45K | $45K | 2.08% |
| CATHERINE LISA LUKE3 | 4787 W HACIENDA AVE CAMPBELL, CA 95008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $653 | $217 | $870 | 2.43% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $672 | — | $672 | 1.87% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE SAN MATEO, CA 94402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $529 | — | $529 | 1.48% |
| MICHAEL KIRKPATRICK3 | P.O. BOX 270 FREEDOM, CA 95050 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $498 | — | $498 | 1.39% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE CT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $256 | — | $256 | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $222 | — | $222 | 0.62% |
| ROSA MURILLO PUENTE3 | 6143 UTE DR SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.22% |
| DOUGLAS LOYAL NERDAHL3 | 4808 NW 77TH STREET OKLAHOMA CITY, OK 73132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.16% |
| SCOTT E BOORE3 Filed as: SCOTT E MOORE | 8 STONEHAVEN CT NOVATO, CA 94947 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.11% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 WEST OREN, UT 84059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.10% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE RD PANAMA CITY, FL 32404 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.07% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $3 | $24 | 0.07% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R AND B ENROLLMENT SERVICES INC | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.06% |
| PATRICIA FERNANDEZ3 | 4646 N 7TH STREET PHOENIX, AZ 85014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.05% |
| REBECCA J MERRITT3 Filed as: REBECCA MERRITT | 927 EAST KEIM DRIVE PHOENIX, AZ 85014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $749 | — | $749 | 6.48% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $0 | $150 | $150 | 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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 375 | $2.2M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 375 | $2.2M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 168 | $12K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 31 | $36K |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 168 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 375 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.