| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIELSEN INSURANCE GROUP INC3 | 4165 EAST THOUSAND OAKS BOULEVARD #325 WESTLAKE VILLAGE, CA 91362 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.85% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVI | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.00% |
| LORI ROBIN NISHIMORI3 | 9204 HOXIE COURT BAKERSFIELD, CA 93311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $351 | $3K | 8.03% |
| NIELSEN INSURANCE GROUP INC3 | 4165 EAST THOUSAND OAKS BOULEVARD WESTLAKE VILLAGE, CA 91362 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.28% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $571 | $174 | $745 | 1.94% |
| INSURICA, INC.3 Filed as: INSURICA CA INSURANCE SERVICES INC | DBA WALTER MORTENSEN INSURANCE BAKERSFIELD, CA 93311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $286 | — | $286 | 0.74% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA BXA INSURANCE SERVICES LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | — | $117 | 0.30% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 0.29% |
| BART EHINGER3 | 715 AVOCET WAY ARROYO GRANDE, CA 93420 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | — | $94 | 0.24% |
| ARACELI MEDINA PANIAGUA3 | 400 ROYAL WAY BAKERSFIELD, CA 93306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 0.22% |
| KRISTIN LEASE3 | 3890 HOWARD AVENUE LOS ALAMITOS, CA 90720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $68 | $82 | 0.21% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 3707 ANITA AVENUE PASADENA, CA 91107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | $7 | $50 | 0.13% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F FAHEY LII | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.11% |
| KIMBERLEY LYNN SCHMALL3 | 9925 NORTH GRANVILLE AVENUE FRESNO, CA 93720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.10% |
| VONDA KAY PERALEZ3 | 6409 RIO DE JANEIRO AVENUE BAKERSFIELD, CA 93313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.09% |
| MCCAREY INC3 | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $1 | $21 | 0.05% |
| CHRISTINE A MILLER3 | 703 RIVERWALK DRIVE UNIT 102 MYRTLE BEACH, SC 29579 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.04% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.02% |
| NIELSEN INSURANCE GROUP INC3 | 228 PARK AVENUE SOUTH PMB 97880 NEW YORK, NY 10003 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 15.81% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE INC DBA ONEDIGITA | 200 GALLERIA PARKWAY SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $145 | $145 | 1.04% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $47K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $47K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $61K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 48 | $38K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $47K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.