| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN W LOWDERMILK3 | STE 325 5600 GREENWOOD PLAZA BLVD GREENWOOD VILLAGE, CO 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 1.78% |
| JOHN W LOWDERMILK3 | STE 325 5600 GREENWOOD PLAZA BLVD GREENWOOD VILLAGE, CO 80111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $27K | — | $27K | 15.00% |
| 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 | 3.33% |
| LORI LAINE3 | 1218 N LINCOLN ST. REDLANDS, CA 92374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $4K | 3.08% |
| RICHARD BLACKSTONE3 | 6374 CHAFFEE ST VENTURA, CA 93003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.86% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $994 | $185 | $1K | 1.01% |
| CLIENT BENEFIT INSURANCE SERVICES3 Filed as: CLIENT BENEFIT INSURANCE SERVICES I | 10769 WOODSIDE AVE SANTEE, CA 92071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $638 | — | $638 | 0.55% |
| VOLUNTARY SOLUTIONS INC3 | 509 SOUTH 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | $29 | $240 | 0.21% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | — | $129 | 0.11% |
| TERIE D BRADFORD3 | 16057 OAKLEY RD. RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | — | $113 | 0.10% |
| BRETT WELTY INSURANCE AGENCY INC3 | 10769 WOODSIDE AVE SANTEE, CA 92071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $81 | — | $81 | 0.07% |
| PATRICIA DANIELS3 Filed as: PATRICIA KATHLEEN DANIELS | 34772 ELMWOOD LN. YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.06% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND KWOKMAN GONG | 1907 COLUMBIA STREET SAN DIEGO, CA 92101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.05% |
| LILIANA RIVERA3 | 25671 TONADILLA CIR MORENO VALLEY, CA 92551 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.03% |
| MCCAREY INC3 | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $7 | $21 | 0.02% |
| MESIROW INSURANCE SERVICES INC3 | 350 NORTH CLARK ST CHICAGO, IL 60610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| RAY MCMARTIN3 | 8045 TABLE MESA WAY COLORADO SPRINGS, CO 80919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON LLC | C/O ASSUREDPARTNERS OF HOUSTON HOUSTON, TX 77036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | P O BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| UNIVERSAL BENEFIT INS AGY3 | C/O ANNABEL CURTIS SAINT GEORGE, UT 84771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JIM BARRETT3 Filed as: JIM BARRET | 8514 EAST KRAIL ST SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| CHERI L ROE3 | P O BOX 22 CRESTON, CA 93432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 | 1003 E COOLEY DR STE 211 COLTON, CA 92324 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| SELECTIVE OPTIONS INC3 | 9720 E 151ST PLACE BRIGHTON, CO 80602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | — | VISION SERVICE PLAN | $4K | — | $4K | 7.96% |
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 | 328 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 651 | $4.1M |
| Dental | BLUE CROSS OF CALIFORNIA | 651 | $4.1M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 651 | $4.2M |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 337 | $631K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 337 | $448K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 337 | $332K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 337 | $631K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.