| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAYMOND DICK3 | 108 VALLEY CREEK COURT FRANKLIN, TN 370644850 | KAISER FOUNDATION HEALTH PLAN INC. | $77K | — | $77K | 4.52% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 927806962 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.41% |
| RAYMOND J DICK3 Filed as: RAYMOND J. DICK | 5155 WEST AVENUE M12 LANCASTER, CA 93536 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 8.31% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.53% |
| KRISTIN LEASE3 | 3890 HOWARD AVENUE LOS ALAMITOS, CA 90720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $4K | $6K | 9.22% |
| RAYMOND J DICK3 Filed as: RAYMOND J. DICK | 108 VALLEY CREEK COURT FRANKLIN, TN 37064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 7.42% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $330 | $4K | 6.38% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $792 | $2K | 3.46% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $138 | $2K | 2.50% |
| MAIRA MAGALI ORTIZ3 | 43642 35TH STREET E LANCASTER, CA 93535 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $33 | $2K | 2.49% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $107 | $1K | 1.77% |
| AMERICA D ESPINOSA3 Filed as: AMERICA D. ESPINOSA | 687 HELEN DRIVE, UNIT 2 OCEANSIDE, CA 92057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $589 | $3 | $592 | 0.94% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $305 | — | $305 | 0.48% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $170 | $258 | 0.41% |
| CHRISTOPHER HAGER3 Filed as: CHRISTOPHER ALLAN | 19920 WINDWOOD CIRCLE RIVERSIDE, CA 92508 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.11% |
| GROUP SUPPLEMENTAL BENEFITS INC3 Filed as: GROUP SUPPLEMENTAL BENEFITS INC. | 39970 STACY COURT MURRIETA, CA 92563 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 0.01% |
| JON MALMBORG3 Filed as: JON CURTIS RICHERT | 35925 LEAH LANE YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 220 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $142K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $142K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $205K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $142K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 220 | $1.7M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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."
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.