| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES | 130 THEORY STE 200 IRVINE, CA 92617 | AETNA HEALTH OF CALIFORNIA INC. | $20K | — | $20K | 3.68% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES INC | 130 THEORY STREET, SUITE 200 IRVINE, CA 926173065 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | — | $3K | 9.96% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $636 | $231 | $867 | 9.82% |
| DAVID A. RACKLIFFE3 Filed as: DAVID A RACKLIFFE | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $547 | $61 | $608 | 6.89% |
| MJ INSURANCE3 Filed as: F.B.P. INSUANCE SERVICES LLC | 130 THEORY ST, STE 200 IRVINE, CA 926173065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $329 | — | $329 | 3.73% |
| MIKE MCCORMICK3 | 348 S STRONGS CT SALT LAKE CITY, UT 84102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.25% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.09% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | P O BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.07% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.06% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $141 | $1K | 16.75% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 2400 E KATELLA AVE STE 1100 ANAHEIM, CA 928065980 | AMERITAS LIFE INSURANCE CORP. | $716 | — | $716 | 10.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 750 B ST STE 2400 SAN DIEGO, CA 921012476 | AMERITAS LIFE INSURANCE CORP. | — | $229 | $229 | 3.20% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $199 | $35 | $234 | 11.79% |
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 | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 75 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA HEALTH OF CALIFORNIA INC. | 93 | $544K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 104 | $35K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 110 | $7K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 111 | $19K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 17 | $9K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 111 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.