| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAURA RUNYEON | 981 QUARRY STREET PETALUMA, CA 94954 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $766 | $300 | $1K | — |
| SALVADOR HEREDIA | 700 EL CAMINITO LIVEMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | $18 | $160 | — |
| GRAND GUILLORY | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | $9 | $75 | — |
| MIKAELA MARIE WOOD | 1087 TWINBERRY ST PLUMAS LAKE, CA 95961 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | $9 | $75 | — |
| ALAYNE MATA | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | — |
| BRIAN ROBERT LLOYD | 6234 KINGS PEAK DR EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $32 | $42 | — |
| DARRYL W VIDOR | 3314 EUROPA ST ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | — |
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 | 21 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 26 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 17 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 17 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.