| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMS AND ASSOCIATES INS. BROKERS3 | 5700 CANOGA AVENUE, SUITE 400 WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $92K | $9K | $101K | 4.57% |
| POMS AND ASSOCIATES INS. BROKERS3 | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | AETNA HEALTH, INC. | $17K | — | $17K | 0.77% |
| POMS AND ASSOCIATES INS. BROKERS3 | 5700 CANOGA AVENUE, SUITE 400 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $31K | $1K | $32K | 5.70% |
| POMS AND ASSOCIATES INS. BROKERS3 | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | AETNA LIFE INSURANCE COMPANY | $7K | -$1K | $5K | 0.99% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS, LLC | 970 RESERVE DRIVE ROSEVILLE, CA 95678 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 7.40% |
| MJ INSURANCE3 Filed as: ANDREA M. TIERCE AND VARIOUS AGENTS | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $339 | $2K | 3.09% |
| CHAD L FRAZIER3 Filed as: CHAD L. FRAZIER | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.10% |
| RICHARD C SUTHERLAND III3 Filed as: RICHARD C. SUTHERLAND | 3601 FIGUEROA STREET GLENDALE, CA 91206 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $862 | $429 | $1K | 1.95% |
| POMS AND ASSOCIATES INS. BROKERS3 | 5700 CANOGA AVENUE WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $537 | — | $537 | 0.81% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $438 | $63 | $501 | 0.76% |
| PAMELA KAY LONG3 | 200 SOUTH LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $419 | — | $419 | 0.63% |
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 | 429 | 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) | 429 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 569 | $2.8M |
| Dental | AETNA LIFE INSURANCE COMPANY | 543 | $556K |
| Vision | AETNA LIFE INSURANCE COMPANY | 543 | $556K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 543 | $622K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 72 | $66K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 543 | $556K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 569 | $2.8M |
| Other | AETNA LIFE INSURANCE COMPANY | 543 | $556K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 569 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.