| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH PLAOKAS Filed as: JOSEPH PLAOUKAS | 525 20TH STREET SAN FRANCISCO, CA 94107 | CHOICE BUILDER | $4K | — | $4K | 9.87% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: WORD & BROWN GENERAL AGENCY | 721 SOUTH PARKER ORANGE, CA 92868 | CHOICE BUILDER | $2K | — | $2K | 3.95% |
| MCCAREY INC | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $1K | $1K | $3K | 9.02% |
| R&B ERNOLLMENT SERVICES INC. | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $1K | $216 | $1K | 4.97% |
| JOHN A. BRADLEY INC. Filed as: JOHN A BRADLEY INC | 207 SOUTH MAINE STREET FOUNTAIN INN, SC 29644 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.66% |
| VINCENT GERARD MCLAUGHLIN Filed as: VINCENT JERAD MCLAUGHILN | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $472 | $365 | $837 | 3.02% |
| ANDREA MARIE TIERCE | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $581 | $135 | $716 | 2.58% |
| CALIFORNIA INSURANCE ADVOCATES INC | 4196 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | $173 | $6 | $179 | 0.65% |
| DAVIDOW FINANCIAL & INSURANCE SERVI | 20700 VENTURA BLVD SUITE 235 WOODLAND HILLS, CA 91364 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $578 | $0 | $578 | 10.00% |
| ALLIANCE INSURANCE GROUP LLC Filed as: ALLIANCE INSURANCE SERVICES INC | 735 E CARNEGIE DRIVE SUITE 200 SAN BERNARDINO, CA 92408 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $243 | $243 | 4.20% |
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 | 84 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 84 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 84 | $414K |
| Dental | CHOICE BUILDER | 54 | $40K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 85 | $6K |
| Other | COLONIAL LIFE AND ACCIDENTAL LIFE INSURANCE COMPANY | 24 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 85 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.