| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | NIPPON LIFE BENEFITS | $161K | $0 | $161K | 4.66% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE COMPANY | $35K | $12K | $47K | 13.19% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | $10K | $33K | 14.55% |
| MCCAREY INC3 | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23K | $11K | $34K | 21.69% |
| MAIRA MAGALI ORTIZ3 Filed as: MAIRA MAGALI ORTIZ & OTHER AGENTS | 43642 35TH STREET EAST LANCASTER, CA 93535 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17K | $4K | $21K | 13.28% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE WOODLAND HILLS, CA 91367 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16K | $0 | $16K | 10.45% |
| RONNY ANN WARNER3 | 470 EAST WHITBECK STREET KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $7K | $14K | 8.66% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DRIVE MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $740 | $4K | 2.51% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $498 | $4K | 2.35% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET CHICAGO, IL 60640 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $786 | $3K | 2.17% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT INS. AGENCY | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | FEDERAL INSURANCE COMPANY | $2K | $34 | $2K | 15.25% |
| MCCAREY INC3 | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | THE PAUL REVERE LIFE INSURANCE COMPANY | $333 | $0 | $333 | 11.31% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DRIVE MURRIETA, CA 92562 | THE PAUL REVERE LIFE INSURANCE COMPANY | $288 | $0 | $288 | 9.78% |
| RONNY ANN WARNER3 | 470 EAST WHITBECK STREET KUNA, ID 83634 | THE PAUL REVERE LIFE INSURANCE COMPANY | $118 | $0 | $118 | 4.01% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET CHICAGO, IL 60640 | THE PAUL REVERE LIFE INSURANCE COMPANY | $86 | $25 | $111 | 3.77% |
| ASSUREDPARTNERS3 Filed as: BERTHA PATRICIA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | THE PAUL REVERE LIFE INSURANCE COMPANY | $47 | $4 | $51 | 1.73% |
| SAMANTHA JACOBS3 Filed as: SAMANTHA JACOBS AND OTHER AGENTS | 5056 PLAZA PROMENADE SAN DIEGO, CA 92123 | THE PAUL REVERE LIFE INSURANCE COMPANY | $32 | $0 | $32 | 1.09% |
| CHRISTOPHER HAUSER3 | 823 DEAL COURT SAN DIEGO, CA 92109 | THE PAUL REVERE LIFE INSURANCE COMPANY | $23 | $0 | $23 | 0.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICE LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 1.83% |
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 | 521 | 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) | 521 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NIPPON LIFE BENEFITS | 695 | $3.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 737 | $355K |
| Vision | AETNA LIFE INSURANCE COMPANY | 737 | $355K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 521 | $229K |
| Short-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 521 | $390K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 521 | $229K |
| Prescription drug | NIPPON LIFE BENEFITS | 695 | $3.5M |
| Other(5 contracts, 5 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 521 | $404K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 737 | — |
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.