| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SIMA BERNER REID3 | 10805 HOLDER ST. STE. 245 CYPRESS, CA 90630 | HEALTH NET | $93K | $0 | $93K | 3.98% |
| TWENTYTWENTY INSURANCE SERVICES3 | 10805 HOLDER ST. STE. 245 CYPRESS, CA 90630 | SIRIUS AMERICA INSURANCE CO | $11K | $0 | $11K | 10.00% |
| SIMA REID3 Filed as: SIMA B. REID | 10805 HOLDER ST. STE. 245 CYPRESS, CA 90630 | GUARDIAN LIFE INSURANCE CO | $12K | $0 | $12K | 12.55% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $3K | $1K | $4K | 4.85% |
| SIMA BERNER REID3 | 3734 MANOR DR. LAKEWOOD, CA 90712 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $2K | $0 | $2K | 2.60% |
| ERIC ALEXANDER NOVOA3 Filed as: ERIC NONOA | 17871 SHADY VIEW DR. CHINO HILLS, CA 91709 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $813 | $357 | $1K | 1.49% |
| LIFE TIME SOLUTIONS LLC3 | 861 KENWOOD ST. UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $860 | $300 | $1K | 1.48% |
| BENEFITS COORDINATOR3 | 29448 TOURS ST. LAKE ELSINOR, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $689 | $217 | $906 | 1.16% |
| EASTMAN AND ASSOCIATES3 Filed as: EASTMAN AND ASSOC INS. SVC., INC | 1637 BAYSIDE DR. CORONA DEL MAR, CA 92625 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $628 | $0 | $628 | 0.80% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLASS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $477 | $16 | $493 | 0.63% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DR. HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $262 | $0 | $262 | 0.33% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL. FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $233 | $0 | $233 | 0.30% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 23522 VIA ALONDRA TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $231 | $0 | $231 | 0.29% |
| RYAN THURSTON WHITTAKER3 | 33011 COMMODORE CT. SAN JUAN CAPO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $218 | $0 | $218 | 0.28% |
| MARIA GONZALEZ3 | 11677 SANDPIPER CT. MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $210 | $0 | $210 | 0.27% |
| ASCENSION BENEFITS ADVISORS3 | 6 POMEGRANATE LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $140 | $0 | $140 | 0.18% |
| INTREPID3 Filed as: INTREPID SOLUTIONS INSURANCE SERVIC | 1500 QUAIL ST. NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $140 | $0 | $140 | 0.18% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST. NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $62 | $57 | $119 | 0.15% |
| MICHAEL JAMES LANCASTER3 | 22365 EL TORO RD. LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $94 | $0 | $94 | 0.12% |
| SADIE BLACKMON3 | 34 WOODCROSS DR. APARTMENT 914 COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $90 | $0 | $90 | 0.11% |
| MARIA VERONICA JARQUE3 | 701 WRELTON DR. SAN DIEGO, CA 92109 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $67 | $0 | $67 | 0.09% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $62 | $0 | $62 | 0.08% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DR. LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $61 | $0 | $61 | 0.08% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DR. BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $57 | $0 | $57 | 0.07% |
| ALI ALEX ROUSHANZAMIR3 | 1639 SPYGLASS DR. CORONA, CA 92883 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $40 | $0 | $40 | 0.05% |
| GABRIEL HOLGUIN3 Filed as: GABRIEL HOGUIN | 2807 GRATTON ST. RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $33 | $1 | $34 | 0.04% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS INC. | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $32 | $0 | $32 | 0.04% |
| MARIANNA REBECCA WEAVER3 | 1301 DOVE ST. STE.340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $25 | $0 | $25 | 0.03% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON ST. RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $17 | $0 | $17 | 0.02% |
| EDWARD J THURIN3 Filed as: EDWARD J. THURIN | 19899 RAY AV. RIVERSIDE, CA 92508 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $8 | $0 | $8 | 0.01% |
| ALEXANDER OTTONIEL CANAS3 | 28677 PLACERVIEW TRAIL SANTA CLARITA, CA 91390 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $7 | $0 | $7 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | P. O. BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $5 | $0 | $5 | 0.01% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $5 | — | $5 | 0.01% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $2 | $0 | $2 | 0.00% |
| SIMA REID3 | 10805 HOLDER ST. STE. 245 CYPRESS, CA 90630 | RELIANCE STANDARD | $4K | $0 | $4K | 10.00% |
| SIMA REID3 Filed as: SIMA B. REID | 10805 HOLDER ST. STE. 245 CYPRESS, CA 90630 | GUARDIAN LIFE INSURANCE CO. | $10K | $0 | $10K | 33.47% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA, INC. | 17901 VAN KARMAN AVE. STE. 1100 IRVINE, CA 92614 | FEDERAL INSURANCE COMPANY | $264 | $0 | $264 | 15.00% |
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 | 400 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 271 | $2.3M |
| Dental | GUARDIAN LIFE INSURANCE CO. | 310 | $31K |
| Vision | RELIANCE STANDARD | 226 | $38K |
| Life insurance | GUARDIAN LIFE INSURANCE CO | 400 | $93K |
| Long-term disability | GUARDIAN LIFE INSURANCE CO | 400 | $93K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE CO | 79 | $115K |
| Other(3 contracts, 3 carriers) | GUARDIAN LIFE INSURANCE CO | 409 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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.
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.