| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | — | $14K | 12.02% |
| AMWINS3 Filed as: LISI LLC | 1600 W. HILLSDALE BLVD, SUITE 201 SAN MATEO, CA 944023766 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $2K | $6K | 4.59% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 13.52% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 8.25% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $446 | $2K | 4.36% |
| ANTOINETTE MARI GARCIA3 | 1745 ORANGEWOOD AVENUE, SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $539 | $2K | 4.21% |
| BENEFITS COORDINATOR3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $887 | $341 | $1K | 3.07% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVENUE, SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $454 | $342 | $796 | 1.99% |
| JESSICA RENEE GREENE3 | 630 S INDIAN HILLS BOULEVARD CLAREMONT, CA 91711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $344 | $54 | $398 | 0.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: TIMOTHY MARTIN BROWN | 2412 NEWTOWN DRIVE HARRISBURG, PA 17110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.22% |
| ANTHONY R MIGLIORE3 | 17112 SANTA RITA STREET FOUNTAIN VALLEY, CA 92708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | — | $59 | 0.15% |
| LUZ CASTILLO BARRIGA3 | 22019 JUAN AVENUE HAWAIIAN GARDENS, CA 90716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | $2 | $55 | 0.14% |
| JONATHAN MARK DAHL3 | 1722 DIXON STREET REDONDO BEACH, CA 90278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.05% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | 201 CAUGHMAN FARM LANE LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $1 | $19 | 0.05% |
| BARBARA K GROSS3 | 15 WEBER ROAD JEANNETTE, PA 15644 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| EDITH VIEYRA3 | 1432 EAST MARKET STREET LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.02% |
| JAMES BARTLETT LLC3 | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $2 | $9 | 0.02% |
| DONNA TROXELL3 | 706 WESTWOOD DRIVE GIBSONIA, PA 15044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| HAD LI ENTERPRISES INCORPORATED3 | 11432 SOUTH STREET, #303 CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| 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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 205 | $416K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 286 | $120K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 286 | $120K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 286 | $160K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 205 | $416K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 286 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 286 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.