| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KINGHORN & ASSOCIATES3 | P.O. BOX 225 BONITA, CA 91908 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 5.52% |
| GEORGE MICHAEL SORRENTINO3 Filed as: GEORGE M SORRENTINO | 1123 ALEXANDRIA DR SAN DIEGO, CA 92107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $5K | $10K | 9.67% |
| KINGHORN & ASSOCIATES3 | P.O. BOX 225 BONITA, CA 91908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 7.34% |
| ROGER STUART KENCHEL3 Filed as: ROGER S KENCHEL | 2588 EL CAMINO ROAD CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 4.87% |
| CHRISTINA D POLK INC3 | 9755 QUENCIA CT LAS VEGAS, NV 89148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $824 | $3K | 2.84% |
| BELLE NATIONAL BENEFITS LLC3 | 9655 WAUKEGAN AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $639 | $2K | 2.15% |
| CHELSEA L WARE LLC3 Filed as: CHELSEA L WARE | 12692 ELISA LANE, UNIT 226 SAN DIEGO, CA 92128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $482 | $2K | 2.04% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND GONG | 2180 FENTON PKWY SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $914 | $305 | $1K | 1.21% |
| G SCOTT COOKE3 Filed as: SCOTT C CASTEEL | 1450 W JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.06% |
| SUZI A ESTRADA3 | 25742 PARK AVENUE SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $563 | — | $563 | 0.56% |
| MARIA E GONZALEZ3 | 9655 WAUKEGAN AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | — | $117 | 0.12% |
| RENAE JO BALL3 | 31376 STRAWBERRY TREE LANE TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.11% |
| CHARLES D SMITH3 | 4040 EAST PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | — | $89 | 0.09% |
| PACIFIC BAY INSURANCE GROUP INC3 | 18301 VON KARMAN AVE IRVINE, CA 92612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.09% |
| MIKE MCCORMICK3 | 348 S STRONGS CT SALT LAKE CITY, UT 84102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | — | $87 | 0.09% |
| SAMAR BREIK ALBIN3 Filed as: SAMAR B ALBIN | 41572 VALOR DR MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $19 | $76 | 0.08% |
| COURTNEY MCFARLAND3 | 7804 SMOKERISE CT LAS VEGAS, NV 89131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| MICHAEL MINNEY3 | P.O. BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DAVID A. RACKLIFFE3 Filed as: DAVID RACKLIFFE | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COASTAL TPA, INC. EIN 77-0523382 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $82K |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 267 | $314K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 115 | $101K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 267 | $213K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 267 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.