| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1039 NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | HEALTH NET | $63K | — | $63K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 10.05% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $523 | $581 | $1K | 6.39% |
| ROSE VILLALON PASQUEL3 | 135 WEST 226TH PLACE CARSON, CA 90745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $605 | $120 | $725 | 4.20% |
| MARIA RUBY QUINTANA3 Filed as: MARIA R. QUINTANA AND OTHER AGENTS | 18214 VIA CALMA ROWLAND HEIGHTS, CA 91748 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $563 | $123 | $686 | 3.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $435 | — | $435 | 2.52% |
| MILLENNIUM CORPORATE SOLUTIONS3 | 5530 TRABUCCO ROAD IRVINE, CA 92620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $221 | — | $221 | 1.28% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $94 | $49 | $143 | 0.83% |
| G SCOTT COOKE3 Filed as: SCOTT C. CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $134 | — | $134 | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE | $1K | — | $1K | 10.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 30001 TAMPA, FL 33601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $298 | $298 | 2.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | CALIFORNIA DENTAL NETWORK, INC. | $494 | — | $494 | 10.00% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 167 | $1.0M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 179 | $64K |
| Vision | EYEMED VISION CARE | 176 | $11K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 169 | $10K |
| Prescription drug | HEALTH NET | 167 | $1.0M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 169 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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.