| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY | $15K | $5K | $20K | 26.28% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD, SUITE 300 KIRKWOOD, MO 63122 | THE GUARDIAN LIFE INSURANCE COMPANY | $643 | — | $643 | 0.84% |
| DAVID A. RACKLIFFE3 | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $39 | $3K | 4.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIEA PARKWAY SE, SUITE 195 ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.97% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 9301 NW 33RD STREET DORAL, FL 33172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $416 | $2K | 3.13% |
| JOHANA HERMILA MEDINA3 | 13265 RIVER OAKDS DRIVE RANCHO CUCAMONGA, CA 91739 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $46 | $1K | 1.64% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $270 | $1 | $271 | 0.38% |
| ADVANCED BENEFIT CENTER, INC.3 Filed as: ADVANCED BENEFIT CENTER INC. | 16145 WHITTIER BOULEVARD WHITTIER, CA 90603 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $218 | — | $218 | 0.30% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE SE | 1920 MAIN STREET IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $215 | — | $215 | 0.30% |
| WILLIAM WAYNE STIGILE3 | 514 GRINDSTONE WOODBRIDGE, CA 95258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $210 | $2 | $212 | 0.30% |
| IWC BENEFIT INSURANCE SERVICES INC.3 | 2450 TAPO STREET SIMI VALLEY, CA 93063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | — | $140 | 0.20% |
| MIKE MCCORMICK3 | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 0.19% |
| JENNIFER AURORA RAMIREZ3 | 1053 FICUS LANE SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $1 | $86 | 0.12% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 0.11% |
| DAVID O CHRISTENSEN3 | 180 MCKNIGHT DRIVE LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.11% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 0.11% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.10% |
| ERICKA MARIA PEREZ3 | 2114 NORTH PACIFIC AVENUE SANTA ANA, CA 92706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.09% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $12 | $31 | 0.04% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DRIVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 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% |
| SOCORRO OLIVIA ALVITRE3 | PO BOX 1876 NORWALK, CA 90651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.02% |
| G SCOTT COOKE3 Filed as: SCOTT C. CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| HURTADO & ASSOCIATES LLC3 | 11309 BORSON STREET NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| RENE HALLEN3 | ATTN RENE HALLEN MIDDLETON, WI 53562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| 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. | $344 | — | $344 | 9.99% |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 215 | $776K |
| Dental(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 53 | $75K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 183 | $148K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 53 | $72K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 183 | $148K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 215 | $704K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 215 | $704K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 183 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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."
No prospect flags tripped on this filing.