| 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 | $16K | $3K | $19K | 24.16% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD, SUITE 300 KIRKWOOD, MO 63122 | THE GUARDIAN LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIEA PARKWAY SE, SUITE 195 ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $293 | $4K | 4.98% |
| DAVID A. RACKLIFFE3 | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1 | $3K | 3.62% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 9301 NW 33RD STREET DORAL, FL 33172 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $278 | $2K | 2.81% |
| JOHANA HERMILA MEDINA3 | 13265 RIVER OAKDS DRIVE RANCHO CUCAMONGA, CA 91739 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $8 | $1K | 1.61% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | — | $233 | 0.30% |
| ADVANCED BENEFIT CENTER, INC.3 Filed as: ADVANCED BENEFIT CENTER INC. | 16145 WHITTIER BOULEVARD WHITTIER, CA 90603 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $227 | — | $227 | 0.29% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE SE | 2100 MAIN STREET, SUITE 350 IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $171 | — | $171 | 0.22% |
| IWC BENEFIT INSURANCE SERVICES INC.3 | 2450 TAPO STREET SIMI VALLEY, CA 93063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.18% |
| MIKE MCCORMICK3 | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.18% |
| JENNIFER AURORA RAMIREZ3 | 1053 FICUS LANE SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $12 | $97 | 0.12% |
| WILLIAM WAYNE STIGILE3 | 514 GRINDSTONE WOODBRIDGE, CA 95258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | — | $94 | 0.12% |
| DAVID O CHRISTENSEN3 | 180 MCKNIGHT DRIVE LAGUNA BEACH, CA 92651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.11% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.10% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 0.09% |
| GOLD RIVER FINANCIAL GROUP LLC3 | 2807 GRATTON STREET RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.04% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DRIVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.03% |
| SOCORRO OLIVIA ALVITRE3 | PO BOX 1876 NORWALK, CA 90651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| HURTADO & ASSOCIATES LLC3 | 11309 BORSON STREET NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| G SCOTT COOKE3 Filed as: SCOTT C. CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 9795 GATEWAY DRIVE RENO, NV 89521 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| RENE HALLEN3 | ATTN RENE HALLEN MIDDLETON, WI 53562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | 1272 W. MORAGA ROAD FRESNO, CA 93711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 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 303395946 | CALIFORNIA DENTAL NETWORK, INC. | $333 | — | $333 | 10.01% |
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 | 198 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 199 | 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 | 231 | $863K |
| Dental(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 53 | $82K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 198 | $159K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 53 | $79K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 198 | $159K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 231 | $784K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 231 | $784K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 198 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.