| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | SHARP HEALTH PLAN | $57K | — | $57K | 4.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $43K | — | $43K | 3.81% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $3K | $9K | 4.71% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $573 | $4K | 11.66% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $373 | $3K | 11.29% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $272 | $5K | 27.28% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $935 | $3K | 15.93% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $801 | $2K | $2K | 14.15% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $85 | $1K | 8.43% |
| WENDY DAWN PACK3 Filed as: WENDY GERSHOW | 3217 STAR AVENUE OAKLAND, CA 94619 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $33 | $1K | 7.27% |
| FERNAN ENRIQUE LOPEZ3 | 735 DOLORES STREET, SUITE 1 SAN FRANCISCO, CA 94110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $180 | $91 | $271 | 1.60% |
| RACHAEL DARLENE DUBE3 | 1013 OAK GLEN IRVINE, CA 92618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $100 | — | $100 | 0.59% |
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 | 464 | 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) | 464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SHARP HEALTH PLAN | 220 | $2.6M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 456 | $210K |
| Vision(2 contracts, 2 carriers) | SHARP HEALTH PLAN | 264 | $1.4M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 464 | $35K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 456 | $185K |
| Prescription drug(2 contracts, 2 carriers) | SHARP HEALTH PLAN | 220 | $2.6M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 464 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 464 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.