| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES I | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 2.98% |
| JOHN W LOWDERMILK3 | 5600 GREENWOOD PLAZA BOULEVARD SUITE 250 GREENWOOD VILLAGE, CA 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 9.41% |
| RICHARD BLACKSTONE3 | 6374 CHAFFEE STREET VENTURA, CA 93003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 4.50% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES I | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 3.88% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $916 | $267 | $1K | 1.17% |
| LORI LAINE3 | 35837 CARTER STREET YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $848 | $278 | $1K | 1.12% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $832 | $293 | $1K | 1.11% |
| RAYMOND KWOCKMAN GONG3 | 2180 FENTON PARKWAY SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $321 | $75 | $396 | 0.39% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS INCORPORATION | 509 SOUTH 4TH AVENUE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $166 | $71 | $237 | 0.23% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $201 | $6 | $207 | 0.21% |
| FREDRICK D BRADFORD3 | 16057 OAKLEY ROAD RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | — | $154 | 0.15% |
| BRETT WELTY INSURANCE AGENCY INC3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $16 | $106 | 0.10% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $15 | $39 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.02% |
| UNIVERSAL BENEFIT INS AGY3 Filed as: UNIVERSAL BENEFIT INSURANCE AGENCY | C/O ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JIM BARRETT3 | 8514 EAST KRAIL STREET SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| CHERI L ROE3 | PO BOX 165 SANTA MARGARITA, CA 93453 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 Filed as: GROUP SUPPLEMENTAL BENEFITS, INC. | 31805 TEMECULA PARKWAY TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JOHN W LOWDERMILK3 | 5600 GREENWOOD PLAZA BOULEVARD SUITE 250 GREENWOOD VILALGE, CO 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 14.83% |
| 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 | 8.46% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 194 | $2.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 238 | $292K |
| Vision | VISION SERVICE PLAN | 231 | $40K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 207 | $376K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 207 | $195K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 207 | $195K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 207 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.