| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SVCS LLC3 | 1800 QUAIL ST STE 110 NEWPORT BEACH, CA 92660 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY/BLUE CROSS OF CA | $59K | — | $59K | 5.01% |
| BENEFITS AMERICA INSURANCE SVCS LLC3 | 1800 QUAIL STREET SUITE 110 NEWPORT BEACH, CA 926602340 | KAISER FOUNDATION HEALTH PLAN, INC. | $29K | — | $29K | 4.14% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $931 | — | $931 | 1.93% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $737 | $14 | $751 | 1.56% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $409 | $7 | $416 | 0.86% |
| SHANIKA M. FISKE3 | 21552 MORESBY WAY LAKE FOREST, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $220 | — | $220 | 0.46% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $122 | $2 | $124 | 0.26% |
| ETHAN ISRAEL CRUZ3 | 244 S 1200 E PAYSON, UT 84651 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $111 | — | $111 | 0.23% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 0.21% |
| CHRISTINE LYNN MORGESTER3 | 14913 S SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.20% |
| ASSUREDPARTNERS3 Filed as: BERTHA PATRICIA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $2 | $56 | 0.12% |
| LILIANA RIVERA3 | 25671 TONADILLA CIR MORENO VALLEY, CA 92551 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.10% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.08% |
| MAIRA MAGALI ORTIZ3 | 43642 35TH ST EAST LANCASTER, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.04% |
| WILLIAM MARC ALVISO3 | 3553 TWOGOOD LANE RIVERSIDE, CA 90501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| JESSICA CHRISTINE LEARD3 | 351 NORTH POST OAK LANE #610 HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.02% |
| DEIRDE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DE 19970 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| TINA HERNANDEZ3 | 11779 W COCOPAH ST AVONDALE, AZ 85323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| JACOB MARK BURNS3 | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| VENBROOK INSURANCE SERVICES3 Filed as: VENBROOK INSURANCE SVCS IRVINE CA | 16815 VON KARMAN AVENUE SUITE 180 IRVINE, CA 92606 | ARMADACARE | $450 | — | $450 | 1.38% |
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 | 135 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY/BLUE CROSS OF CA | 715 | $1.9M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY/BLUE CROSS OF CA | 715 | $1.2M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY/BLUE CROSS OF CA | 715 | $1.2M |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY/BLUE CROSS OF CA | 715 | $1.2M |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 52 | $48K |
| Prescription drug(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY/BLUE CROSS OF CA | 715 | $1.9M |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 52 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 715 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.