| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | CALIFORNIA PHYSICIANS' SERVICE | $75K | — | $75K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $6K | 16.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $317 | — | $317 | 3.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E. KATELLA AVE., SUITE 550 ANAHEIM, CA 92806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | — | $165 | 1.62% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.62% |
| BENEFITS COMMUNICATIONS INC. (BCI)3 Filed as: BENEFITS COMMUNICATIONS INC | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.42% |
| RYAN THURSTON WHITTAKER3 | 33011 COMMODORE CT SAN JUAN CAPO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.37% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 23522 VIA ALONDRA TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.35% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.16% |
| MICHAEL F FAHEY III3 | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.12% |
| SADIE BLACKMON3 | 34 WOODCROSS DR, APT 914 COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.07% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $359 | — | $359 | 5.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVC OF CA | 2401 E KATELLA AVE, SUITE 550 ANAHEIM, CA 92806 | UDC DENTAL OF CALIFORNIA, INC | $516 | — | $516 | 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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 109 | $1.5M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 18 | $21K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $53K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 16 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $35K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 109 | $1.5M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.