| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | BLUE CROSS OF CALIFORNIA | $75K | $0 | $75K | 4.42% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $0 | $35K | $35K | 2.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | SCANION GUERRA BURKE INSURANCE WOODLAND HILLS, CA 91365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $168 | $14K | 9.09% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $5K | $11K | 7.64% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R&B ENROLLMENT SERVICES INC | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $518 | $4K | 2.37% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $655 | $3K | 1.91% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $882 | $201 | $1K | 0.73% |
| ROSE VILLALON PASQUEL3 | 135 W 226TH PLACE CARSON, CA 90745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $775 | $135 | $910 | 0.61% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INSURANCE ADVOCATES INC. | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $803 | $0 | $803 | 0.54% |
| ELTHON ISRAEL CRUZ3 | 3800 WEST DEVONSHIRE AVENUE HEMET, CA 92545 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $391 | $60 | $451 | 0.30% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $382 | $0 | $382 | 0.26% |
| UZIEL RIVERA3 | 543 CHEROKEE CIR BANNING, CA 92220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $136 | $0 | $136 | 0.09% |
| CRYSTAL MARIE BISHOP3 | 2571 LARAMIE ROAD RIVERSIDE, CA 92506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | $0 | $108 | 0.07% |
| MARIA RUBY QUINTANA3 | 18214 VIA CALMA ROWLAND HEIGHTS, CA 91748 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $60 | $92 | 0.06% |
| MARIA C GONZALEZ3 | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 0.06% |
| MARIA YVONNE RODIGHIERO3 | 28502 SHRIKE DRIVE LAGUNA NIGUEL, CA 92677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | $0 | $73 | 0.05% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON STREET FILLMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $29 | $61 | 0.04% |
| JAKORP INC3 Filed as: JAKORP INC. | 15254 WINESPRINGS CT SAN DIEGO, CA 92127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $23 | $56 | 0.04% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE, #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $9 | $55 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $16 | $48 | 0.03% |
| LUIS ERNESTO PEREZ3 | 861 KENWOOD ST UPLAND, CA 91784 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.02% |
| JOSEPH RUBINO3 | 1806 BRABHAM ST EL CAJON, CA 92019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 0.02% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.02% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $6 | $24 | 0.02% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.01% |
| ERIC BROGAN3 Filed as: ERIC L MILLER | 4505 W PIONEER DR IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| ANTIONE T TURNER3 | 1929 B GATES AVE REDONDO BEACH, CA 90278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| HECTOR MARTINEZ3 | 843 MALTMAN AVE LOS ANGELES, CA 90026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | $0 | $3K | 6.31% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $2K | $2K | 4.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLGHER BENEFIT SERVICES, INC. | 45 RIVER PARK PLACE WEST SUITE 605 FRESNO, CA 93720 | ANTHEM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | $0 | $1K | $1K | 15.00% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 389 | $1.7M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 389 | $1.8M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 389 | $45K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 389 | $45K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 24 | $7K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 389 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.