| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275K | $44K | $319K | 29.81% |
| EOI SERVICE COMPANY INC3 | 1820 E FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | TRUSTMARK INSURANCE COMPANY | $9K | — | $9K | 4.39% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | TRUSTMARK INSURANCE COMPANY | $4K | — | $4K | 1.88% |
| DEBBIE A HILLIARD3 | PO BOX 5213 OCEANSIDE, CA 92052 | AMERICAN HERITAGE LIFE INSURANCE COMPANY DBA ALLSTATE | $56 | — | $56 | 0.20% |
| DEBBIE M BRADY3 | 250 S ROSE DRIVE, SPC 21 PLACENTIA, CA 92870 | AMERICAN HERITAGE LIFE INSURANCE COMPANY DBA ALLSTATE | $15 | — | $15 | 0.05% |
| BENEFITELECT INC.3 Filed as: BENEFITELECT INS SVCS INC | COMMUNICATION PARTNERS INC 132 SW CROWELL WAY, SUITE 200 BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY DBA ALLSTATE | $13 | — | $13 | 0.05% |
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 | 4,703 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,733 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 3,116 | $21.0M |
| Dental | SAFEGUARD HEALTH PLANS, INC. | 611 | $37K |
| Vision | GERBER LIFE INSURANCE COMPANY | 3,216 | $236K |
| Life insurance(4 contracts, 4 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 307 | $1.3M |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 183 | $1.1M |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 183 | $1.1M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 3,116 | $21.0M |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 4,703 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,703 | — |
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.