| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FBP INSURANCE SERVICES3 | 130 THEORY, STE 200 IRVINE, CA 92617 | BLUE SHIELD OF CALIFORNIA | $19K | — | $19K | 4.00% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES LLC | 130 THEORY STREET, SUITE 200 IRVINE, CA 926173065 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 9.95% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P INSURANCE SERVICES, LLC | 130 THEORY STREET, SUITE 200 IRVINE, CA 926170000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $896 | $199 | $1K | 9.52% |
| DAVID A. RACKLIFFE3 Filed as: DAVID A RACKLIFFE | 300 HERIOT CT SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $874 | $101 | $975 | 8.48% |
| FBP INSURANCE SERVICES3 Filed as: FBP INSURANCE SEVICES INC | 130 THEORY IRVINE, CA 92617 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $467 | — | $467 | 4.06% |
| MIKE MCCORMICK3 | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.15% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.05% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| 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. | $653 | — | $653 | 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. | — | $170 | $170 | 2.60% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $873 | $73 | $946 | 14.63% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $270 | $34 | $304 | 10.27% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 85 | $470K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 95 | $52K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 114 | $7K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $21K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 16 | $12K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 85 | $470K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.
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.