| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHY HALO INSURANCE SERVICES INC3 Filed as: HEALTHY HALO INSURANCE SERVICES,INC | 3727 W MAGNOLIA BLVD #829 BURBANK, CA 91505 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $35K | $35K | 1.90% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 2601 LARMAR RD LOS ANGELES, CA 90068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 6.37% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $9 | $1K | 2.45% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $410 | $25 | $435 | 0.84% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $283 | $57 | $340 | 0.66% |
| KRISTIN LEASE3 | 3890 HOWARD AVE LOS ALAMITOS, CA 90720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | $198 | $303 | 0.59% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $286 | $0 | $286 | 0.55% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | $0 | $137 | 0.27% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES, INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $0 | $113 | 0.22% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 WEST OREM, UT 84059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | $0 | $87 | 0.17% |
| LUIS ERNESTO PEREZ3 Filed as: LUIS PEREZ BENEFIT INSURANCE SOLUTI | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.06% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.04% |
| DEBRA JEAN HUMPHREY3 | 1325 MARDI LN HOUSTON, TX 77055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.04% |
| RANDELL LYNN KRUSE3 | 2018 DAYTON COURT SE RENTON, WA 98055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.04% |
| MARIA VERONICA JARQUE3 | 4744 N PAULINA ST APT 1E CHICAGO, IL 60640 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.03% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.03% |
| WENDY SUE GERSHOW3 | 3217 STAR AVE OAKLAND, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.03% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DR. GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.03% |
| JUDY INEZ BUCHOLTZ3 Filed as: JUDY I BUCHHOLTZ | 12517 217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.03% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 3707 ANITA AVE PASADENA, CA 91107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.02% |
| JANICE D RUCKS3 | 691 S BYHALIA RD APT 338 COLLIERVILLE, TN 38017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 3727 W MAGNOLIA BLVD. #829 BURBANK, CA 91502 | VISION SERVICE PLAN | $474 | $0 | $474 | 3.01% |
| HEALTHY HALO INSURANCE SERVICES INC3 Filed as: HEALTHY HALO INSURANCE SERVICES,INC | 3727 W MAGNOLIA BLVD #829 BURBANK, CA 91505 | SUN LIFE ASSURANCE COMPANY OF CANADA | $871 | $0 | $871 | 7.50% |
| MCCAREY INC3 Filed as: MCCAREY INC DBA ESSENTIAL BENEFITS | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | SUN LIFE ASSURANCE COMPANY OF CANADA | $871 | $0 | $871 | 7.50% |
| HEALTHY HALO INSURANCE SERVICES INC3 | 515 S. FLOWER ST., 36TH FLOOR LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $630 | $0 | $630 | 9.97% |
| HEALTHY HALO INSURANCE SERVICES INC3 Filed as: HEALTHY HALO INSURANCE SERVICES,INC | 3727 W MAGNOLIA BLVD #829 BURBANK, CA 91505 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $630 | $0 | $630 | 10.00% |
| HEALTHY HALO INSURANCE SERVICES INC3 Filed as: HEALTHY HALO INSURANCE SERVICES,INC | 515 S. FLOWER ST., 36TH FLOOR LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $3K | $0 | $3K | — |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 180 | $1.8M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 187 | $6K |
| Vision | VISION SERVICE PLAN | 100 | $16K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 130 | $58K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 19 | $12K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 180 | $1.8M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 130 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.