| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | AETNA HEALTH OF CALIFORNIA INC | $103K | — | $103K | 4.46% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 913614026 | AETNA HEALTH OF CALIFORNIA INC | $21K | — | $21K | 0.89% |
| ELIZABETH REYNERTSON3 | 8513 DAY ST SUNLAND, CA 91040 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $6K | — | $6K | 6.36% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $5K | — | $5K | 5.07% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, CA 83634 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1K | $14 | $1K | 1.36% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE UNIT 112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1K | $57 | $1K | 1.24% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $967 | — | $967 | 1.05% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $675 | $182 | $857 | 0.93% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $497 | $37 | $534 | 0.58% |
| SHANE G ROSS3 | 620 E CABERNET COURT UPLAND, CA 91786 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $233 | — | $233 | 0.25% |
| ELIZABETH J DOWNEY3 | 2883 OAKWOOD DR PORT HURON, MI 48060 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $69 | — | $69 | 0.07% |
| UNIVERSAL BENEFIT INS AGY3 | C/O ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $16 | — | $16 | 0.02% |
| DEBORAH ALEXAKOS3 | 1727 WEST GREENHEAD DR MERIDIAN, ID 83642 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $8 | — | $8 | 0.01% |
| COHR INCORPORATED3 | 10510 TWIN LAKE PARKWAY CHARLOTTE, NC 28269 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $8 | — | $8 | 0.01% |
| NOEL HASERT3 | 5104 E AZALEA CIR SIOUX FALLS, SD 57108 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $6 | — | $6 | 0.01% |
| JIM BARRETT3 | 8514 EAST KRAIL ST SCOTTDALE, 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 | $1 | — | $1 | 0.00% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN AND ASSOCIATES INCORPORATED | 9795 GATEWAY DR RENO, NV 89521 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1 | — | $1 | 0.00% |
| JON MALMBORG3 Filed as: JON CURTIS RICHERT | 183 SAWGRASS LN CALIMESA, CA 92320 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1 | — | $1 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 | 1003 EAST COOLEY DR COLTON, CA 92324 | COLONIAL LIFE AND ACCIDENT INS COMPANY | $1 | — | $1 | 0.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 2.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 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 | 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 INSURANCE COMPANY | $2K | — | $2K | 8.13% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $229 | — | $229 | 0.90% |
| BEAUMARC GROUP INC3 | PO BOX 33242 LONG BEACH, CA 908323242 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $769 | — | $769 | 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 | 344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC | 283 | $2.4M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 191 | $135K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 297 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 344 | $94K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 222 | $31K |
| Prescription drug | AETNA HEALTH OF CALIFORNIA INC | 283 | $2.3M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 423 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 423 | — |
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.