| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEMBER BENEFITS INSURANCE SERVICES3 | 26050 ACERO MISSION VIEJO, CA 92691 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208K | — | $208K | 11.37% |
| TEN FOUR FINANCIAL INC3 | 1338 KETTNER BLVD SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69K | — | $69K | 3.75% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36K | $7K | $44K | 2.38% |
| MICHAEL KAVOUKLIS3 Filed as: MICHAEL TODD O GRADY | 3598 EVENING CANYON ROAD OCEANSIDE, CA 92056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $526 | $12K | 0.63% |
| RACHAEL DARLENE DUBE3 | 9 FRANCES BARBER DR HOPE VALLEY, RI 02832 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $232 | $5K | 0.30% |
| MARIA MERCEDES TOGNOLI3 | 5 GIVERNY NEWPORT COAST, CA 92657 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 0.21% |
| VOLUNTARY BENEFIT ADVISORS3 | 1936 E. DEERE AVE SANTA ANA, CA 92705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $573 | — | $573 | 0.03% |
| MICHELLE CARLOTTA HARDAWAY3 | 947 E. TWILL CT ANAHEIM, CA 92804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $385 | — | $385 | 0.02% |
| BOB BLAKE & ASSOCIATES INC3 | 444 W. OCEAN BLVD. STE 1404 LONG BEACH, CA 90802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $163 | — | $163 | 0.01% |
| CARMEN LOPEZ3 | 4655 WEST 1ST STREET LOS ANGELES, CA 90004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $163 | — | $163 | 0.01% |
| M B ELLISON INC3 | 834 E. 4TH STREET LONG BEACH, CA 90802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.01% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $5 | $89 | 0.00% |
| SHARI ILENE BIALICK ROSEMBLAT3 | 1846 HI POINT ST LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 0.00% |
| KATHY JO ANDERSON3 | 4323 YOSEMITE WAY LOS ANGELES, CA 90065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.00% |
| YOLO ENTERPRISE INC3 | 5460 E. EL PRAQUE ST LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.00% |
| JILLIAN AMBER SHARP3 | 5914 EAST PAVO STREET LONG BEACH, CA 90808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | — | $59 | 0.00% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SERVICES WEST I | P.O. BOX 905494 CHARLOTTE, NC 28290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 | 1003 E. COOLEY DR STE 211 COLTON, CA 92324 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.00% |
| JOSEPH L. AGAGON3 Filed as: JOSEPH LYLE AGAGON | 3999 LEWIS AVE LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.00% |
| JOHN M FICKEWIRTH AND ASOC3 | P.O. BOX 3617 VENTURA, CA 93006 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.00% |
| JANELLE MARIE AGAGON3 | 3999 LEWIS AVE LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.00% |
| CARLOS MENDEZ3 | 1936 E. DEERE AVE STE 215 SANTA ANA, CA 92705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.00% |
| GIOVANNA HUGHES3 | P.O. BOX 1161 STUDIO CITY, CA 91614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.00% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.00% |
| BILLY WALKER3 | 406 WEST LINDEN DR ORANGE, CA 92865 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.00% |
| TAMARA BRANCH3 | 3989 S. ORANGE DRIVE LOS ANGELES, CA 90008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.00% |
| ANDRE CRENSHAW3 | 44676 LIBERTY AVE LA QUINTA, CA 92253 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.00% |
| MARTIN A MANNINGS3 | 3553 ATLANTIC AVE LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| NICOLE LORRAINE MCFARLAND3 | 16966 TURK DRIVE LA PUENTE, CA 91744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| LISA ANN DIMON3 | C/O LISA DIMON AUBURN, CA 95602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| VALOR BENEFITS3 | 12125 KOUDEKERK STREET ARTESIA, CA 90701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| CHISOLM & ASSOCIATED INSURANCE SERV3 | 12368 ANDY STREET CERRITOS, CA 90702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| ARETHA GREEN3 | 4280 VIA ARBOLADA LOS ANGELES, CA 90042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| THERESA S MOULTRIE3 | 12350 DEL AMO BLVD LAKEWOOD, CA 90715 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| CORNER BEAR INC3 | 15904 KENNARD STREET HACIENDA HEIGHTS, CA 91745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| RUBIN G HAIRSTON3 | 5645 CAROLINE STREET MONTCLAIR, CA 91763 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | P.O. BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| JAMES STEVEN POWELL3 | 3811 OLMSTED AVE LOS ANGELES, CA 90008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MARIA JOHNSON3 | 7112 FORD DRIVE HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| MIKE MCCORMICK3 | 7 MONSERRAT PL FOOTHILL RANCH, CA 92610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ELAINE L ALEXANDER3 | C/O ELANIE ALEXANDER SARATOGA, CA 95070 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BELL INSURANCE GROUPS LLC3 | 23816 RIDGE POINT CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JANE CONKLIN MILLER3 | 8566 FALLBROOK CIRCLE HUNTINGTON BEACH, CA 92646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ROY LEE TUCKER3 | P.O. BOX 41031 PASADENA, CA 91114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| KEVIN FITZGERALD HOWARD3 | P.O. BOX 71315 OAKLAND, CA 94612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| EVA MARGARETA COLLIN3 | 6447 HANES RD NORTH ST PETERSBURG, FL 33714 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| PTW INSURANCE SERVICES3 | P.O. BOX 27098 FRESNO, CA 93729 | RSLI | $61K | — | $61K | 10.61% |
| PTW INSURANCE SERVICES3 | P.O. BOX 27098 FRESNO, CA 93729 | AIG | $10K | — | $10K | 17.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Other services; Claims processing Service code 12 | — | $1.4M |
| EPLAN EIN 20-3720767 NONE | Consulting (general); Claims processing; Direct payment from the plan Service code 12 | — | $862K |
| ARISTOTLE CAPITAL MANAGEMENT, LLC EIN 95-4833644 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $706K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $468K |
| CBRE GLOBAL INVESTORS EIN 95-4752098 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $384K |
| KEYSTONE NATIONAL GROUP EIN 20-5150678 NONE | Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $333K |
| CITYSCAPE IT PROS EIN 46-1791445 NONE | Direct payment from the plan; Other services; Consulting (general) Service code 16 | — | $267K |
| PACIFIC INVESTMENTS EIN 77-0583390 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $200K |
| BASYS, INC. EIN 52-1796473 NONE | Other commissions; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $191K |
| REGINALD CYRUS EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $168K |
| AMERICAN REALTY ADVISORS EIN 33-0123114 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $162K |
| CAROL MOORE EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $142K |
| DEBBIE LINK EIN 95-3846189 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| BASYS INC | Other commissions Service code 55 | — | $101K |
| JOSE MORALES EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| MARTINA MOJICA EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| GLORIA AVITIA EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| DANA TENEYCK EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| MELANIE TALSMA EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| MINA CARRANZA EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| NATALIE VASQUEZ EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| FRANK TIMPANI EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| DANIELLA MARTINEZ EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| MERCER HUMAN RESOURCE NONE | Consulting (general); Direct payment from the plan; Other services Service code 16 | 17901 VON KARMAN AVENUE SUITE 1100 IRVINE, CA 92614 | $71K |
| CAROLINE RYAN EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| YVONNE SAUNDERS EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| MISTY LOPEZ EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| DEBBIE MARTINI EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| DALANA YOUNG EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| POLOMA PUBLIC AFFAIRS EIN 83-0883342 NONE | Direct payment from the plan; Other services Service code 49 | — | $62K |
| PRECISION DOCUMENT IMAGING EIN 30-0162043 NONE | Direct payment from the plan; Other services Service code 49 | — | $60K |
| MARK BINNS EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| DONNA BEHAN EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| SONIA GUERRERO EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| JESSIE MALDONADO EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| MARK GAZMIN EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| ALMA DIAZ EIN 95-3846186 NONE | Consulting (general); Other services; Direct payment from the plan Service code 16 | — | $53K |
| CONSIDINE & ASSOCIATES, INC NONE | Direct payment from the plan; Consulting (general); Other services Service code 16 | 25401 CABOT RD 200 LAGUNA HILLS, CA 92595 | $53K |
| ANADALLAS BIZZELL EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $51K |
| LEIA MASHAKA CONSULTING NONE | Direct payment from the plan; Consulting (general) Service code 16 | 9045 IRON CACTUS AVE LAS VEGAS, NV 89148 | $49K |
| ANA CRUZ EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $41K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $41K |
| EXPRESS SCRIPTS NONE | Direct payment from the plan; Claims processing Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $34K |
| J. NIDOME EIN 95-3846186 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $30K |
| PROPHARMA PHARMACEUTICAL EIN 95-4081972 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $29K |
| MARVIN PAULL NONE | Actuarial; Direct payment from the plan Service code 11 | CLINTON KEITH ROAD, 114-241 WILDOMAR, CA 92595 | $29K |
| BANK OF AMERICA NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | 101 SOUTH TRYON STREET CHARLOTTE, NC 28202 | $28K |
| L. EBREO EIN 95-3846186 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $27K |
| FAIR HEALTH INC EIN 90-0524293 TRUSTEE | Other services; Consulting (general); Direct payment from the plan Service code 16 | — | $27K |
| DON LASSIG EIN 95-3846186 NONE | Direct payment from the plan; Trustee (individual); Named fiduciary Service code 20 | — | $21K |
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 | 2,925 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,158 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,083 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 634 | $2.0M |
| Long-term disability | RSLI | 1,513 | $573K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 634 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,513 | — |
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.