| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE COMPANY | $30K | $13K | $43K | 17.20% |
| DAVID A. RACKLIFFE3 | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $242 | $4K | 6.81% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $498 | $2K | 4.17% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARWAY SE, SUITE 1950 ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $749 | $77 | $826 | 1.44% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE SV | 1920 MAIN STREET IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $367 | — | $367 | 0.64% |
| ADVANCED BENEFIT CENTER, INC.3 Filed as: ADVANCED BENEFIT CENTER INC. | PO BOX 844 LA HABRA, CA 90633 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $256 | — | $256 | 0.45% |
| WILLIAM WAYNE STIGILE3 | 514 GRINDSTONE WOODBRIDGE, CA 95258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $195 | $2 | $197 | 0.34% |
| MIKE MCCORMICK3 | 348 S STRONGS COURT SALT LAKE CITY, UT 84102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.25% |
| IWC BENEFIT INSURANCE SERVICES INC.3 | 2450 TAPO STREET SIMI VALLEY, CA 93063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.25% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.14% |
| DAVID O CHRISTENSEN3 | 180 MCKNIGHT DRIVE LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.14% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 0.14% |
| GABRIEL HOLGUIN3 | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 0.13% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.12% |
| SOCORRO OLIVIA ALVITRE3 | PO BOX 1876 NORWALK, CA 90651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $3 | $40 | 0.07% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DRIVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.04% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $4 | $20 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.03% |
| PACIFIC BAY INSURANCE GROUP INC3 Filed as: PACIFIC BAY INSURANCE GROUP, INC. | 18301 VON KARMAN AVENUE IRVINE, CA 92612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.03% |
| G SCOTT COOKE3 Filed as: SCOTT C. CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.03% |
| HURTADO & ASSOCIATES LLC3 Filed as: HURTADO & ASSOCIATES, LLC | 13948 HALCOURT AVENUE NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.03% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| RENE HALLEN3 | ATTN RENE HALLEN MIDDLETON, WI 53562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| HAD LI ENTERPRISES INCORPORATED3 Filed as: HAD II ENTERPRISES INCORPORATED | 11432 SOUTH STREET, #303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.01% |
| VALOR BENEFITS3 | 12125 KOUDEKERK STREET ARTESIA, CA 90701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JIM BARRETT3 | 8514 EAST KRAIL STREET SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA DENTAL NETWORK, INC. | $906 | — | $906 | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | — |
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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 226 | $0 |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 324 | $259K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 324 | $250K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 324 | $307K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 41 | $57K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 324 | $307K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 226 | $0 |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 226 | $0 |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 324 | $250K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.