| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | AETNA HEALTH OF CALIFORNIA INC | $87K | — | $87K | 5.17% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 913614026 | AETNA HEALTH OF CALIFORNIA INC | $17K | — | $17K | 1.03% |
| ELIZABETH REYNERTSON3 | 8513 DAY ST SUNLAND, CA 91040 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $6K | — | $6K | 7.57% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $4K | — | $4K | 5.22% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1K | $288 | $1K | 1.76% |
| MCCAREY INC3 | 965 MESA DR CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $572 | $353 | $925 | 1.24% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DR TEHACHAPI, CA 93561 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $445 | $297 | $742 | 0.99% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA RD WESTLAK VILLAGE, CA 91361 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $691 | — | $691 | 0.93% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AV UNIT 112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $481 | $64 | $545 | 0.73% |
| SHANE G ROSS3 | 8721 PREDERA CT RANCHO CUCAMONGA, CA 91730 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $364 | — | $364 | 0.49% |
| ELIZABETH J DOWNEY3 | 2883 OAKWOOD DR PORT HURON, MI 480601794 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $75 | — | $75 | 0.10% |
| UNIVERSAL BENEFIT INS AGY3 | CO ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $18 | — | $18 | 0.02% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DR MERIDIAN, ID 83642 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $9 | — | $9 | 0.01% |
| NOEL HASERT3 | 5104 E AZALEA CIR SIOUX FALLS, SD 571082796 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $9 | — | $9 | 0.01% |
| COHR INCORPORATED3 | 10510 TWIN LAKE PARKWAY CHARLOTTE, NC 28269 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $6 | — | $6 | 0.01% |
| JIM BARRETT3 | 8514 EAST KRAIL ST SCOTTSDALE, AZ 85250 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $6 | — | $6 | 0.01% |
| HURTADO & ASSOCIATES LLC3 Filed as: HURTADO AND ASSOCIATES LLC | 11309 BORSON ST NORWALK, CA 90650 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $4 | — | $4 | 0.01% |
| GROUP SUPPLEMENTAL BENEFITS INC3 | 1003 EAST COOLEY DR COLTON, CA 92324 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $2 | — | $2 | 0.00% |
| JON MALMBORG3 Filed as: JON CURTIS RICHERT | 183 SAWGRASS LN CALIMESA, CA 92320 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $2 | $0 | $2 | 0.00% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN AND ASSOCIATES INC | 11412 ROBBIA DR LAS VEGAS, NV 89138 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1 | — | $1 | 0.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 2.00% |
| BEUAMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| 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 908323242 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | ANTHEM BLUE CROSS LIFE AND HEALTH INS CO | $2K | — | $2K | 8.25% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | ANTHEM BLUE CROSS LIFE AND HEALTH INS CO | $206 | — | $206 | 0.92% |
| 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 | $712 | — | $712 | 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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC | 223 | $1.8M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 181 | $116K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INS CO | 267 | $22K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 279 | $76K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $25K |
| Prescription drug | AETNA HEALTH OF CALIFORNIA INC | 223 | $1.7M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 391 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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.