| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVS INC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS | $15K | — | $15K | 0.95% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVS INC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 3.00% |
| JOHN W LOWDERMILK3 | 5600 GREENWOOD PLAZA BOULEVARD SUITE 250 GREENWOOD VILLAGE, CA 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 9.39% |
| RICHARD BLACKSTONE3 | 653 VERDANT PLACE VISTA, CA 92084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $85 | $13K | 10.40% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVS | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 5.19% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $324 | $83 | $407 | 0.32% |
| VOLUNTARY SOLUTIONS INC3 | 195 TELLURIDE STREET BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $248 | $127 | $375 | 0.29% |
| FREDRICK D BRADFORD3 | 16057 OAKLEY ROAD RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $234 | — | $234 | 0.18% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.02% |
| UNIVERSAL BENEFIT INS AGY3 | C/O ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| JIM BARRETT3 | 8514 EAST KRAIL STREET SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| CHERI L ROE3 | PO BOX 165 SANTA MARGARITA, CA 93453 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 Filed as: GROUP SUPPLEMENTAL BENEFITS, INC. | 31805 TEMECULA PARKWAY TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JOHN W LOWDERMILK3 | 5600 GREENWOOD PLAZA BOULEVARD SUITE 250 GREENWOOD VILALGE, CO 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 12.15% |
| HEALTHSMART BENEFIT SOLUTIONS3 Filed as: HEALTHSMART BENEFIT SOLUTIONS, INC. | 10303 EAST DRY CREEK ROAD SUITE 200 ENGLEWOOD, CO 80112 | VISION SERVICE PLAN | $3K | $180 | $3K | 8.35% |
| JOHN W LOWDERMILK3 | 5600 GREENWOOD PLAZA BOULEVARD STE 250 GREENWOOD VILLAGE, CO 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.25% |
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 | 195 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS | 195 | $2.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 196 | $248K |
| Vision | VISION SERVICE PLAN | 193 | $34K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 175 | $372K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 175 | $174K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 175 | $174K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 175 | $372K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.