| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W FIFTH STREET OXNARD, CA 93030 | BLUE CROSS OF CALIFORNIA | $61K | $0 | $61K | 4.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 21600 OXNARD STREET, #650 WOODLAND HILLS, CA 91365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2 | $3K | 9.99% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $718 | $25 | $743 | 2.28% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $296 | $2 | $298 | 0.92% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INS. ADVOCATES INC. | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $250 | $0 | $250 | 0.77% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $183 | $0 | $183 | 0.56% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R&B ENROLLMENT SERVICES | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | $0 | $108 | 0.33% |
| LIFE TIME SOLUTIONS LLC3 | 861 KENWOOD STREET UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $0 | $100 | 0.31% |
| ELTHON ISRAEL CRUZ3 | 3800 WEST DEVONSHIRE AVENUE HEMET, CA 92545 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $0 | $69 | 0.21% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $0 | $64 | 0.20% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $1 | $43 | 0.13% |
| MARTHA R BAEZ3 | 2179 OLD BRIDGE ROAD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.08% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.08% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT GERARD MCLAUGHLIN | 30320 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $11 | $26 | 0.08% |
| RONNY ANN WARNER3 | 470 E WHITBECK STREET KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.02% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| LISA ANN MCLAUGHLIN3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: BARKLEY INSURANCE & RISK MANAGEMENT | 143 W FIFTH STREET OXNARD, CA 93030 | EYEMED VISION CARE | $2K | $0 | $2K | 9.03% |
| THE INSURANCE GROUP3 Filed as: INSURANCE GROUP | 143 W FIFTH STREET OXNARD, CA 93030 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 326 | $1.4M |
| Dental | HUMANA INSURANCE COMPANY | 151 | $175K |
| Vision | EYEMED VISION CARE | 245 | $22K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 174 | $45K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 174 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.