| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHY HALO INSURANCE SERVICES INC3 | 110 W PROVIDENCIA AVE SUITE 101 BURBANK, CA 91502 | CALIFORNIA PHYSICIANS SERVICE | $4K | $100K | $105K | 4.99% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 2601 LARMAR RD LOS ANGELES, CA 90068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 6.07% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.50% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $540 | $0 | $540 | 0.84% |
| DEL DOWNEY3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $448 | $0 | $448 | 0.70% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES, INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $0 | $202 | 0.31% |
| ELTHON ISRAEL CRUZ3 | 244 S 1200 E PAYSON, UT 84651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $189 | $0 | $189 | 0.29% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $0 | $157 | 0.24% |
| RANDELL LYNN KRUSE3 | 2018 DAYTON CT SE RENTON, WA 98055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.07% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.06% |
| DOUGLAS LOYAL NERDAHL3 Filed as: DOUGLAS LOYAL NERDAHI | 4808 NW 77TH STREET OKLAHOMA CITY, OK 73132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 0.06% |
| LIFE TIME SOLUTIONS LLC3 | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.05% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.04% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DR. GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.04% |
| DEBRA JEAN HUMPHREY3 | 1325 MARDI LN HOUSTON, TX 77055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.03% |
| MARIA VERONICA JARQUE3 | 4085 NOBEL DR. #29 SAN DIEGO, CA 92122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.03% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.03% |
| WENDY DAWN PACK3 Filed as: WENDY GERSHOW | 3217 STAR AVE OAKLAND, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.03% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY I BUCHHOLTZ | 12517 217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.02% |
| ALLEN MAIRS3 | PO BOX 696 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.02% |
| MARIANNA REBECCA WEAVER3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.01% |
| SUSAN J LEACH3 | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| JANICE D RUCKS3 | 1204 CHAMBERLAIN NO. 4 MEMPHIS, TN 38119 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 110 W PROVIDENCIA AVE SUITE 101 BURBANK, CA 91502 | VISION SERVICE PLAN | $454 | $0 | $454 | 2.75% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 110 W PROVIDENCIA AVE SUITE 101 BURBANK, CA 91502 | SUN LIFE ASSURANCE COMPANY OF CANADA | $749 | $0 | $749 | 7.50% |
| MCCAREY INC3 Filed as: MCCAREY INC. DBA ESSENTIAL BENEFITS | 965 MESA DR CAMARILLO, CA 93010 | SUN LIFE ASSURANCE COMPANY OF CANADA | $749 | $0 | $749 | 7.50% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 110 W PROVIDENCIA AVE SUITE 101 BURBANK, CA 91502 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $828 | $0 | $828 | 10.00% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 515 S. FLOWER ST., 36TH FLOOR LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $655 | $0 | $655 | 10.00% |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 215 | $2.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 33 | $7K |
| Vision | VISION SERVICE PLAN | 105 | $17K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 146 | $73K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 16 | $10K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 215 | $2.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 146 | $73K |
| 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."
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.