| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BEAUMARC GROUP INC3 | DBA BEAUMARC INSURANCE SERVICES PO BOX 33242 LONG BEACH, CA 908143242 | CALIFORNIA PHYSICIANS SERVICE | $55K | — | $55K | 5.00% |
| ELIZABETH REYNERTSON3 | 4725 ROSEBANK DRIVE LA CANADA, CA 91011 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $251 | $12K | 16.49% |
| BEAUMARC GROUP INC3 Filed as: BEAUMARC GROUP INC. | PO BOX 33242 LONG BEACH, CA 908323242 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 11.16% |
| RICHARD WILLIAM FRIEDMAN3 | 23927 RUSTICO CT SANTA CLARITA, CA 91354 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $1K | $6K | 7.94% |
| SHANE G ROSS3 | 8721 PREDERA CT RANCHO CUCAMONGA, CA 91730 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $698 | $4K | 5.89% |
| THOMAS ROBERT LOGAN3 | 27701 BARRETT DRIVE SANTA CLARITA, CA 91350 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $54 | $2K | 3.00% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $725 | $488 | $1K | 1.62% |
| RICHARD C SUTHERLAND III3 | 3601 FIGUEROA STREET GLENDALE, CA 91206 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $717 | $289 | $1K | 1.35% |
| ELIZABETH J DOWNEY3 | 6113 N CUMBERLAND ROAD MUNCIE, IN 47304 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $169 | — | $169 | 0.23% |
| UNIVERSAL BENEFIT INS AGY3 Filed as: UNIVERSAL BENEFIT INSURANCE AGENCY | C/0 ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.07% |
| RENE HALLEN3 | ATTN RENE HALLEN MIDDLETON, WI 53562 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.04% |
| DEBORAH ALEXAKOS3 | 5475 N MITHCUM AVE MERIDIAN, ID 83646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.03% |
| JIM BARRETT3 | 8514 EAST KRAIL STREET SCOTTSDALE, AZ 85250 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| VINCENT GERARD MCLAUGHLIN3 | 4739 MASCAGNI STREET VENTURA, CA 93003 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.01% |
| COHR INCORPORATED3 | 10510 TWIN LAKE PARKWAY CHARLOTTE, NC 28269 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| HUTARDO AND ASSOCIATES INC3 | 13948 HALCOURT AVE NORWALK, CA 90650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN AND ASSOCIATES INCORPORATED | 3601 FIGUEROA STREET GLENDALE, CA 91206 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 2.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 5.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 90832 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | HOLMAN FAMILY COUNSELING INC | $570 | — | $570 | 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 | 220 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 323 | $101K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.1M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $59K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $21K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.1M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 297 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.