| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 100 PINE STREET, 11TH FLOOR SAN FRANCISCO, CA 94111 | BLUE CROSS OF CALIFORNIA | $257K | — | $257K | 4.30% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $8K | $22K | 4.71% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $32K | $5K | $36K | 11.46% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET SAN DIEGO, CA 92101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $68 | $6K | 7.02% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $812 | $4K | 4.26% |
| DAVID SPARKS PURVIS3 | 3840 SADDLE BEND DRIVE OLIVE BRANCH, MS 38654 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $510 | $3K | 2.93% |
| MJ INSURANCE3 Filed as: ARLAN E NAWABI AND VARIOUS AGENTS | 201 DARLINGTON IRVINE, CA 92620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $209 | $2K | 2.50% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $702 | $2K | 1.98% |
| RAMONA MARGARET DALY3 | 402 CAMINO BANDERA SAN CLEMENTE, CA 92673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $728 | — | $728 | 0.80% |
| RONALD RAY GRETZ3 | 8131 ASHBROOK DRIVE SOUTHAVEN, MS 38671 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $523 | — | $523 | 0.57% |
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 | 710 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 32 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 757 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 1,315 | $6.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,114 | $481K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,114 | $481K |
| Life insurance(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 427 | $423K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 427 | $408K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 427 | $316K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,315 | $6.0M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 427 | $316K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,315 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.