| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 0.33% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $2K | $5K | 10.39% |
| BRYSON INSURANCE AGENCY INC.3 Filed as: BRYSON INSURANCE AGENCY, INC. | 3777 LONG BEACH BOULEVARD, FL 5 LONG BEACH, CA 908073325 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 4.94% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD HAUPPAUGE, NY 117883914 | PRINCIPAL LIFE INSURANCE COMPANY | — | $1K | $1K | 2.05% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N. MAIN STREET, SUITE 800 SANTA ANA, CA 927056687 | PRINCIPAL LIFE INSURANCE COMPANY | — | $880 | $880 | 1.77% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $913 | $3K | 10.44% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $351 | $3K | 10.26% |
| TECH COORDINATOR CYBER INSURANCE SO3 | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $683 | $127 | $810 | 2.82% |
| KRISTIN ANN DECOU3 | 751 ROBIN GLEN ROAD BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $198 | — | $198 | 0.69% |
| ANTOINETTE MARI GARCIA3 | 905 EVENING CANYON ROAD BREA, CA 92821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $168 | — | $168 | 0.59% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVENUE, SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | — | $105 | 0.37% |
| ERIC ALEXANDER NOVOA3 | 17871 SHADY VIEW DRIVE CHINO HILLS, CA 91709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.04% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.03% |
| JESSICA RENEE GREENE3 | 714 WILLIAMS DRIVE, APT B HUNTINGTON BEACH, CA 92648 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.03% |
| DONNA TROXELL3 | 526 SCAIFE ROAD SEWICKLEY, PA 15143 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| BRYSON INSURANCE AGENCY INC.3 | 3777 LONG BEACH BOULEVARD, STE 500 LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| EDITH VIEYRA3 | 1432 EAST MARKET STREET LONG BEACH, CA 90805 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 | 1028 FREEDOM STREET LITITZ, PA 17543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| JAMES BARTLETT LLC3 | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 180 | $368K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 180 | $368K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 268 | $50K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 268 | $79K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 25 | $29K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 180 | $368K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 268 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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."
No prospect flags tripped on this filing.