| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FBP INSURANCE SERVICES3 Filed as: FBP INSURANCE SVCS LLC | 130 THEORY STREET #200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $61K | — | $61K | 4.04% |
| MCGRIFF INSURANCE SERVICES INC3 | 541 NORTH MAIN STREET STE 100 MOUNT AIRY, NC 27030 | BLUE CROSS OF CALIFORNIA | — | $2K | $2K | 0.14% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 130 THEORY STREET #200 IRVINE, CA 92660 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 10.17% |
| SUSIE A ESTRADA3 | 25742 PARK AVENUE SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.67% |
| G SCOTT COOKE3 Filed as: SCOTT C CASTEEL | 1450 WEST JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $887 | $15 | $902 | 2.13% |
| GREGORY ALFRED MOORE3 | 14 DEODAR IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $855 | — | $855 | 2.01% |
| RALPH F REA JR3 | 84 VIA BARCELONA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $465 | $1 | $466 | 1.10% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | 2100 MAIN ST STE 350 IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $238 | — | $238 | 0.56% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 2100 ROSS AVE STE 1200 DALLAS, TX 75201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $222 | — | $222 | 0.52% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $171 | — | $171 | 0.40% |
| KENNETH D WONG3 | PO BOX 11810 MARINA DEL REY, CA 90292 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $135 | — | $135 | 0.32% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.16% |
| RONDA KAYE ECKHARDT3 | 130 THEORY SUITE 200 IRVINE, CA 92617 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.13% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.13% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM CT. MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.10% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.05% |
| DUSTIN SNYDER3 | 34606 SHALLOT DR WINCHESTER, CA 92596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| MCGRIFF INSURANCE SERVICES INC3 | 130 THEORY SUITE 200 IRVINE, CA 92617 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $1K | — | $1K | 5.75% |
| MCGRIFF INSURANCE SERVICES INC3 | 130 THEORY SUITE 200 IRVINE, CA 92617 | HOLMAN FAMILY COUNSELING, INC. | $224 | — | $224 | 5.00% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 249 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $177K |
| Vision | VISION SERVICE PLAN | 129 | $18K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $177K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $220K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $177K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 161 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.