| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS, INC. | 221 MAIN STREET UNIT 1462 LOS ALTOS, CA 94023 | CALIFORNIA PHYSICIANS SERVICE | $2K | $77K | $79K | 4.22% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS, INC | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | $39K | — | $39K | 2.08% |
| MICHAEL KIRKPATRICK3 | P.O. BOX 270 FREEDOM, CA 95050 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $314 | — | $314 | 1.13% |
| MIKE RADAKOVICH3 | 221 MAIN STREET LOS ALTOS, CA 94023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $224 | — | $224 | 0.80% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $133 | — | $133 | 0.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 0.43% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE CT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $81 | — | $81 | 0.29% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE SAN MATEO, CA 94402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.12% |
| SCOTT E BOORE3 Filed as: SCOTT BOORE | 1680 DELTA WIND LANE LINCOLN, CA 95648 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.09% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 WEST OREN, UT 84059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.08% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE ROAD PANAMA CITY, FL 32404 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.08% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R&B ENROLLMENT SERVICES INC. | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.05% |
| PATRICIA FERNANDEZ3 | 4534 E DEVONSHIRE AVE PHOENIX, AZ 85018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.04% |
| REBECCA J MERRITT3 Filed as: REBECCA MERRITT | 927 EAST KEIM DRIVE PHOENIX, AZ 85014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| SUSAN HENDRICKS3 | 6718 N PALM CANYON DRIVE PHOENIX, AZ 85018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD PHOENIX, AZ 85018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS, INC. | 221 MAIN STREET UNIT 1462 LOS ALTOS, CA 94023 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS, INC | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $209 | — | $209 | 2.00% |
| MIKE RADAKOVICH3 | 221 MAIN STREET UNIT 1462 LOS ALTOS, CA 94023 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 20.00% |
| ANT FARM3 | 291 HERTIAGE WALK WOODSTOCK, GA 30188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $411 | — | $411 | 5.01% |
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 | 197 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 414 | $1.9M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 414 | $1.9M |
| Life insurance(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 190 | $19K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 27 | $28K |
| Other(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 190 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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.