| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GROUP BENEFITS AND INSUR | P.O. BOX 3387 SEAL BEACH, CA 90740 | BLUE CROSS OF CALIFORNIA | $74K | — | $74K | 5.40% |
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GROUP BENEFITS AND INSUR | P.O. BOX 26457 SANTA ANA, CA 927996457 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 10.14% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICES INC. | 1600 W. HILLSDALE BLVD, SUITE 201 SAN MATEO, CA 944023766 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $4K | $7K | 6.33% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE COMPANY | $967 | — | $967 | 0.86% |
| ANTOINETTE MARI GARCIA3 | 1745 ORANGEWOOD AVENUE, SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $6K | $10K | 32.50% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVENUE, SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $3K | $4K | 13.85% |
| JESSICA RENEE GREENE3 | 630 S INDIAN HILLS BOULEVARD CLAREMONT, CA 91711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: TIMOTHY MARTIN BROWN | 2412 NEWTOWN DRIVE HARRISBURG, PA 17110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $875 | $81 | $956 | 3.17% |
| ANTHONY R MIGLIORE3 | 17112 SANTA RITA STREET FOUNTAIN VALLEY, CA 92708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $419 | $446 | $865 | 2.86% |
| LUZ CASTILLO BARRIGA3 | 22019 JUAN AVENUE HAWAIIAN GARDENS, CA 90716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $198 | $61 | $259 | 0.86% |
| BARBARA K GROSS3 | 15 WEBER ROAD JEANNETTE, PA 15644 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 0.76% |
| JONATHAN MARK DAHL3 | 1722 DIXON STREET REDONDO BEACH, CA 90278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $172 | — | $172 | 0.57% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $30 | $88 | 0.29% |
| JAMES BARTLETT LLC3 | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $1 | $43 | 0.14% |
| DONNA TROXELL3 | 706 WESTWOOD DRIVE GIBSONIA, PA 15044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $6 | $34 | 0.11% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARTLETT | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $8 | $24 | 0.08% |
| EDITH VIEYRA3 | 1432 EAST MARKET STREET LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.05% |
| HADI LI ENTERPRISES INCORPORATED3 | 11432 SOUTH STREET, #303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.03% |
| ANAHI RIES3 | 1110 OHIO AVENUE LONG BEACH, CA 90804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 248 | $1.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 291 | $113K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 291 | $113K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 291 | $143K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 248 | $1.4M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 291 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.