| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC. Filed as: WORD & BROWN GENERAL AGENCY | 721 SOUTH PARKER ORANGE, CA 92868 | CHOICE BUILDER | $1K | — | $1K | 4.00% |
| MCCAREY INC | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $1K | $982 | $2K | 6.97% |
| R & B ENROLLMENT SERVICES INC | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $995 | $209 | $1K | 4.10% |
| CALIFORNIA INSURANCE ADVOCATES INC Filed as: CALIFORNIA INSURNACE ADVOCATES INC | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $177 | — | $177 | 0.60% |
| INSYNC BENEFITS INC | P.O BOX 1474 CORNELEIUS, NC 28031 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $12 | $5 | $17 | 0.06% |
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES INC | 735 EAST CARNEGIE DRIVE, SUITE 200 SAN BERNANDINO, CA 92408 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $539 | $211 | $750 | 13.90% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 88 | $423K |
| Dental | CHOICE BUILDER | 48 | $33K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $5K |
| Other | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | 23 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 91 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.