| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCAREY INC3 | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $193 | $3K | 3.56% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $103 | $1K | 1.79% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA M. TIERCE | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $635 | $109 | $744 | 1.05% |
| DONNA ROSS SMITH3 Filed as: DONNA MARIE WARREN | 4142 N 25TH ST. APT 23 PHOENIX, AZ 85016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $502 | $17 | $519 | 0.73% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $384 | — | $384 | 0.54% |
| JENNIFER JOHNS3 | 3401 TEPUSQUET CANYON RD SANTA MARIA, CA 93454 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $200 | — | $200 | 0.28% |
| DEL DOWNEY3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $125 | — | $125 | 0.18% |
| BRETT ALLAN DYKSTRA3 | 930 KUMQUAT PLACE OXNARD, CA 93036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.14% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: KERWIN VAUGH BROWN | 1939 E MISSOURI AVE, APT 5 PHOENIX, AZ 85016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $21 | $96 | 0.14% |
| JOHN A. BRADLEY INC.3 Filed as: JOHN A BRADLEY, INC. | 207 SOUTH MAIN ST FOUNTAIN INN, SC 29644 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.09% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.07% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.05% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DR. MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.04% |
| CLARICE D LEWIS LLC3 Filed as: CLARICE D LEWIS, LLC | 8631 STONEFACE ROAD CHARLOTTE, NC 28214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| MIKE MCCORMICK3 | 7 MONSERRAT PLACE SALT LAKE CITY, UT 84102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| HURTADO & ASSOCIATES LLC3 | 13948 HALCOURT AVE NORWALK, CA 90650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| PATRICIA FERNANDEZ3 | 1113 W MONTE CRISTO AVENUE PHOENIX, AZ 85023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| WILLIAM KYZER3 | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
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 | 69 | 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) | 69 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 69 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 69 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.