| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 21.26% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $4K | 10.97% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.39% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $973 | $1K | $2K | 6.94% |
| MARY DAUGHERTY3 | 7625 STAR GAZING LANE KNOXVILLE, TN 37938 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $456 | $363 | $819 | 2.45% |
| ERNESTO ELOY GARCIA3 | 4710 FALLON PLACE DALLAS, TX 75227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $467 | $301 | $768 | 2.30% |
| BARBARA ANN BASTON3 | 5401 MANSEL LANE FORT WORTH, TX 76134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275 | $261 | $536 | 1.60% |
| PENELOPE ROSAS3 | 7300 HENNEMAN WAY MCKINNEY, TX 75070 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $294 | $35 | $329 | 0.98% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $164 | $286 | 0.86% |
| RUBEN D PEREZ3 | 6352 ALCORN AVENUE DALLAS, TX 75217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $264 | — | $264 | 0.79% |
| TRACY HANAGRIFF3 | 3312 RIVERWALK DRIVE BATON ROUGE, LA 70820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $228 | — | $228 | 0.68% |
| TERRELL & COMPANY INC3 Filed as: TERRELL AGENCY INC. | 242 GULFWAY DRIVE HACKBERRY, LA 70645 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $217 | — | $217 | 0.65% |
| YESENIA A SANCHEZ3 Filed as: YESENIA A HERNANDEZ | 4037 W. 63RD STREET CHICAGO, IL 60629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $177 | $29 | $206 | 0.62% |
| 44 CAPITAL GROUP INC.3 | 1207 W. WHYTECLIFFE ROAD PALATINE, IL 60067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $203 | — | $203 | 0.61% |
| MPART BENEFITS INC3 | 4621 GLEN HEATHER DRIVE FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $100 | $163 | 0.49% |
| MARIA VANDYKE3 Filed as: MARIA ESCALONA | PO BOX 202587 ARLINGTON, TX 76006 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | — | $156 | 0.47% |
| ALEXANDER V CAPRARO3 | 2012 N. 77TH AVENUE ELMWOOD PARK, IL 60707 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.45% |
| KAREN TYLER-DUNN3 | 714 SEYMOUR DRIVE FRISCO, TX 75033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $133 | — | $133 | 0.40% |
| TANYA MIRIAM KAKON3 | 98 ABALONE LANE EAST PONTE VEDRA BEACH, FL 32082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | $3 | $124 | 0.37% |
| DAVID J MCCLELLAN3 Filed as: DAVID GORDON EARL | 289 REDWOOD AVE ELK GROVE VILLAGE, IL 60007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.26% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DRIVE KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | $11 | $79 | 0.24% |
| JOANNA MAIRA MCGOWEN3 | 47 SANTA AGATHA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.22% |
| ALBERTO VALENZUELA3 | 3108 ROUNDTREE LANE GARLAND, TX 75044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.22% |
| INOCENCIA MAY CRAWFORD3 | 3055 FOOTHILL BLVD, #3 LA CRESCENTA, CA 91214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $2 | $65 | 0.19% |
| JULIAN OLALDE3 | 10935 ESTATE LANE DALLAS, TX 75238 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.15% |
| GARY FANCHER INSURANCE PLLC3 | 1918 COOPER DRIVE IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $1 | $42 | 0.13% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $18 | $40 | 0.12% |
| ROSA SHALA3 | 16112 HARBOUR VISTA CIR. ST. AUGUSTINE, FL 32080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.12% |
| JOSHUA T JONES3 | 25 GARFIELD LANE STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.11% |
| CREATIVE EMPLOYEE BENEFIT SERVICES3 | PO BOX 83278 BATON ROUGE, LA 70884 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $5 | $38 | 0.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: STACY J. BROWN | 412 S CHANNEL DRIVE ROUND LAKE BEACH, IL 60073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $2 | $38 | 0.11% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE ROAD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $11 | $38 | 0.11% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $20 | $35 | 0.10% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE, #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $10 | $29 | 0.09% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 1550 HARRINGTON PARK DRIVE JACKSONVILLE, FL 32225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $3 | $21 | 0.06% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $10 | $20 | 0.06% |
| DEL DOWNEY3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.06% |
| BSK BENEFITS PLUS LLC3 | 585 BEAU CHENE DRIVE MANDEVILLE, LA 70471 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.05% |
| ROXY KUGLER3 | 20031 LOUISIANA HWY 16 DENHAM SPRINGS, LA 70726 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.05% |
| FELTER INC3 Filed as: FELTER INC. | 5403 COMMONWEALTH AVE WESTERN SPRINGS, IL 60558 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.04% |
| NORMITA JOHNSON3 | 9817 TUSCARORA DRIVE BAKERSFIELD, CA 93312 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.04% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $3 | $15 | 0.04% |
| OTAVIUS MANUEL ORTIZ3 | 785 TUCKER ROAD, SUITE G136 TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| DAVID TODD WEINSTEIN3 | 601 W JACKSON BLVD, SUITE 912 CHICAGO, IL 60661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS INC. | 5655 OAKHURST DRIVE SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $2 | $8 | 0.02% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.01% |
| BARRY W MAAS3 | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| THERESA NETTO PHILLIPS3 | 6219 S. CLARA FRESNO, CA 93706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.01% |
| BRANDON MARCELLO CENTO3 | 7060 OAKBAY DRIVE NOBLESVILLE, IN 46062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.01% |
| ADELINA GUADALUPE ORTIZ3 | 22000 GOLDEN STAR BLVD TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| PARRISH J PEACHEE3 | 109 N UNION STREET WESTFIELD, IN 46074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 9.74% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $971 | — | $971 | 9.91% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $869 | — | $869 | 9.70% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 19.99% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA DENTAL NETWORK, INC. | $97 | — | $97 | 10.02% |
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 | 793 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 797 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 1,387 | $618K |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 576 | $40K |
| Vision | STANDARD INSURANCE COMPANY | 574 | $8K |
| Life insurance | STANDARD INSURANCE COMPANY | 846 | $10K |
| Short-term disability | STANDARD INSURANCE COMPANY | 731 | $9K |
| Long-term disability | STANDARD INSURANCE COMPANY | 846 | $15K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 1,387 | $618K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 846 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,387 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.