| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22K | $3K | $25K | 19.50% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 7.78% |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALEZ | 11677 SANDPIPER COURT MORENO VALLEY, CA 92557 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $782 | $8K | 5.95% |
| TECH COORDINATOR CYBER INSURANCE SO3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $5K | 3.51% |
| SARAH COURTNEY KNAPP3 Filed as: SARAH COURTNEY KNAP | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 3.38% |
| CHRISTOPHER ALLAN AND OTHER AGENTS3 Filed as: CHRISTOPHER ALLEN AND OTHER AGENTS | 19920 WINDWOOD CIRCLE RIVERSIDE, CA 92508 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $254 | $4K | 2.78% |
| LUIS ERNESTO PEREZ3 Filed as: LUIS PEREZ BENEFIT INSURANCE SOL. | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $660 | $3K | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $5K | $193 | $5K | 4.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3655 NOBEL DRIVE SAN DIEGO, CA 92122 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $0 | $2K | 10.03% |
| 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 | 9.25% |
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 | 234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 19 | $101K |
| Dental(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 177 | $152K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 217 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 234 | $31K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 19 | $101K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 234 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.