| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | AETNA HEALTH OF CALIFORNIA, INC. | $91K | $0 | $91K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $10K | $52 | $10K | 4.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $323 | $4K | 4.56% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $483 | $3K | 2.90% |
| MJ INSURANCE3 Filed as: NDG INS. SVCS. & VARIOUS AGENTS | 29122 RANCHO VIEJO ROAD SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $128 | $2K | 1.75% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR STREET LADERA RANCH, CA 92694 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $148 | $1K | 1.33% |
| TECH COORDINATOR CYBER INSURANCE SO3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $728 | $0 | $728 | 0.81% |
| JIMMY ALEXANDER TORRES3 | 1700 WEST CERRITOS AVENUE SUITE 117 ANAHEIM, CA 92804 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $683 | $8 | $691 | 0.77% |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALEZ | 11677 SANDPIPER COURT MORENO VALLEY, CA 92557 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $502 | $29 | $531 | 0.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 6.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3655 NOBEL DRIVE SAN DIEGO, CA 92122 | UNITED CONCORDIA INSURANCE COMPANY | $3K | $755 | $3K | 13.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3655 NOBEL DRIVE SAN DIEGO, CA 92122 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $0 | $2K | 9.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | $0 | $1K | 9.99% |
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 | 252 | 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) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 341 | $2.0M |
| Dental(3 contracts, 3 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 164 | $139K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 189 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 252 | $36K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 341 | $2.0M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 252 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 341 | — |
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.