| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 39000 SAN FRANCISCO, CA 94139 | UNITEDHEALTHCARE INSURANCE COMPANY | $30K | — | $30K | 3.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 6701 CENTER DRIVE WEST, SUITE 1500 LOS ANGELES, CA 90045 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 2.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 9.00% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $465 | $5 | $470 | 2.20% |
| MJ INSURANCE3 Filed as: CHARLES D. SMITH AND VARIOUS AGENTS | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $192 | $2 | $194 | 0.91% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $122 | $6 | $128 | 0.60% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 WEST 187TH PLACE TORRANCE, CA 90504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $109 | — | $109 | 0.51% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $2 | $107 | 0.50% |
| CALVIN DEAN INGLE3 | 1840 LARIAT TRAIL CELINA, TX 75009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $94 | — | $94 | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203334 DALLAS, TX 75320 | UNIMERICA LIFE INSURANCE SERVICES | $588 | — | $588 | 7.15% |
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 | 239 | 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) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $998K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $977K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $977K |
| Life insurance(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $1.0M |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $977K |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 248 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.