| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DER MANOUEL INSURANCE GROUP3 Filed as: DER MANOUEL INS. AND FIN. SVCS. INC | PO BOX 28906 FRESNO, CA 93729 | BLUE CROSS OF CALIFORNIA | $36K | $0 | $36K | 4.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | PO BOX 3310 SANTA BARBARA, CA 93130 | BLUE CROSS OF CALIFORNIA | $0 | $16K | $16K | 1.90% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SVCS. INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $0 | $10K | $10K | 1.23% |
| BENEFIT COORDINATOR3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $310 | $1K | 9.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 548 WEST CROMWELL AVENUE FRESNO, CA 93711 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $847 | $59 | $906 | 5.86% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $750 | $93 | $843 | 5.45% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $229 | $104 | $333 | 2.15% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | 1272 WEST MORAGA ROAD FRESNO, CA 93711 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $124 | $16 | $140 | 0.91% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $109 | $0 | $109 | 0.70% |
| KATHLEEN SPILLMAN-OREL3 | 1499 OLD MOUNTAIN ROAD SAN JACINTO, CA 92583 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $0 | $84 | 0.54% |
| DER MANOUEL INSURANCE GROUP3 | PO BOX 28906 FRESNO, CA 93729 | VISION SERVICE PLAN | $759 | $0 | $759 | 7.36% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 189 | $839K |
| Dental | BLUE CROSS OF CALIFORNIA | 189 | $839K |
| Vision | VISION SERVICE PLAN | 69 | $10K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 189 | $839K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 189 | $839K |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 189 | $855K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.