| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | BLUE CROSS OF CALIFORNIA | $28K | — | $28K | 4.96% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $6K | — | $6K | 0.98% |
| ELIZABETH REYNERTSON3 | 4725 ROSEBANK DRIVE LA CANADA, CA 91011 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.64% |
| BEAUMARC GROUP INC3 Filed as: BEAUMARC GROUP INC. | PO BOX 33242 LONG BEACH, CA 908323242 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $969 | $0 | $969 | 2.95% |
| SHANE G ROSS3 | 8721 PREDERA CT RANCHO CUCAMONGA, CA 91730 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $236 | $1 | $237 | 0.72% |
| MCCAREY INC3 | 965 MESA DR CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $119 | $36 | $155 | 0.47% |
| RICHARD WILLIAM FRIEDMAN3 | 23927 RUSTICO CT SANTA CLARITA, CA 91354 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $145 | $0 | $145 | 0.44% |
| VINCENT GERARD MCLAUGHLIN3 | 30310 HORSETHIEF DR TEHACHAPI, CA 93561 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $32 | $116 | 0.35% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $97 | — | $97 | 0.30% |
| ELIZABETH J DOWNEY3 | 2883 OAKWOOD DR PORT HURON, MI 48060 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.15% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.15% |
| NOEL HASERT3 | 5104 E AZALEA CIR SIOUX FALLS, SD 57108 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $9 | $24 | 0.07% |
| UNIVERSAL BENEFIT INS AGY3 | C/O ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.03% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DR MERIDIAN, ID 83642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| RENE HALLEN3 | ATTN RENE HALLEN MIDDLETON, WI 53562 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| JIM BARRETT3 | 9514 EAST KRAIL ST SCOTTSDALE, AZ 85250 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| COHR INCORPORATED3 | 10510 TWIN LAKE PARKWAY CHARLOTTE, NC 28269 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| HUTADO AND ASSOCIATES LLC3 | 13823 WOODRUFFF AVE BELLFLOWER, CA 90706 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN AND ASSOCIATES INC | 11412 ROBBIA DR LAS VEGASRITA, NV 89138 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $526 | — | $526 | 2.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 5.00% |
| 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 | $1K | — | $1K | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $981 | — | $981 | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | HOLMAN FAMILY COUNSELING INC | $310 | — | $310 | 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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 172 | $605K |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 158 | $50K |
| Vision | BLUE CROSS OF CALIFORNIA | 172 | $573K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 242 | $31K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $10K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 172 | $573K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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.