| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHEN WHITE3 | 2400 WATERMARK BLVD. OKLAHOMA CITY, OK 73134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $5K | $11K | 3.52% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DR. MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $2K | $9K | 3.10% |
| CRAIG F KINGHORN3 Filed as: CRAIG F KIGHORN | PO BOX 211236 CHULA VISTA, CA 91921 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 2.85% |
| PJNP INC3 | 310 S TWIN OAKS VLY RD # 107-2 SAN MARCOS, CA 92078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $3K | $8K | 2.79% |
| ACRIALPS LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 1.71% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $995 | $4K | 1.17% |
| KINGHORN & ASSOCIATES3 Filed as: KINGHORN & ASSOCIATES INS | PO BOX 211236 CHULA VISTA, CA 91921 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.88% |
| G SCOTT COOKE3 Filed as: SCOTT C CASTEEL | 1450 W JAMES WAY ANAHEIM, CA 92801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $454 | — | $454 | 0.15% |
| SUSIE A ESTRADA3 | S25742 PARK AVE SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $268 | — | $268 | 0.09% |
| ROGER STUART KENCHEL3 | 2588 EL CAMINO REAL STE F188 CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 0.08% |
| RALPH F REA JR3 | 84 VIA BARCELONA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 0.04% |
| BARBARA ELLEN SMITH3 | 4040 EAST PIEDMONT DR. SPC 228 HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.02% |
| RAYMOND KWOCKMAN GONG3 | 1907 COLUMBIA ST APT 501 SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.02% |
| CHELSEA L WARE LLC3 | 233 W 21ST ST. NEW YORK, NY 89149 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.02% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.01% |
| MARTHA ANGELICA HILL ESTRADA3 | 2991 ESCALA CIR SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.01% |
| LUKE SALERNO3 Filed as: LUKE A SALERNO | 3985 CARMEL BROOKS WAY SAN DIEGO, CA 92130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| COURTNEY MCFARLAND3 | 8321 W SAHARA AVE APT 2128 LAS VEGAS, NV 89117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| JOHN D EVANGELISTA3 | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| KINGHORN & ASSOCIATES3 | PO BOX 211236 CHULA VISTA, CA 91921 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 20.00% |
| KINGHORN & ASSOCIATES3 Filed as: KINGHORN, CRAIG | PO BOX 211236 CHULA VISTA, CA 91921 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 10.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CENTRIX BENEFIT ADMINISTRATORS, INC EIN 77-0523382 THIRD PARTY | Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | P.O. BOX 212199 CHULA VISTA, CA 770523382 | $175K |
| KINGHORN & ASSOCIATES NONE | Claims processing; Insurance brokerage commissions and fees; Contract Administrator Service code 12 | 817 BOW SPRIT ROAD SUITE 200 CHULA VISTA, CA 91914 | $93K |
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 | 335 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 225 | $302K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 225 | $302K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 333 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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.