| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRINCIPAL BENEFIT INS. SOLUTIONS3 | 355 SOUTH GRAND AVENUE, SUITE 2540 LOS ANGELES, CA 90071 | UNITEDHEALTHCARE INSURANCE COMPANY | $258K | $0 | $258K | 4.20% |
| WEST BENEFITS INS. MARKETING, INC.3 | 655 VALLEYWOOD CIRCLE CORONA, CA 92879 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $0 | $1K | 0.02% |
| PBI INSURANCE SOLUTIONS, LLC3 | 355 SOUTH GRAND AVENUE, SUITE 2450 LOS ANGELES, CA 90071 | SIMNSA | $13K | $0 | $13K | 7.00% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $3K | $8K | 4.70% |
| PRINCIPAL BENEFIT INS. SOLUTIONS3 | 355 SOUTH GRAND AVENUE, SUITE 2540 LOS ANGELES, CA 90071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 4.17% |
| WEST BENEFITS INSUR MKTG, INC.3 Filed as: WEST BENEFITS INSURANCE MARKETING | PO BOX 3056 CORONA, CA 92878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 4.01% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $329 | $2K | 1.18% |
| ELITESOLUTIONS LTD AND OTHER AGENTS3 | 2682 EMERALD STREET LOVELAND, CO 80537 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $141 | $2K | 0.94% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET APARTMENT 1E CHICAGO, IL 60640 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $229 | $1K | 0.81% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $163 | $1K | 0.79% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 5.66% |
| PRINCIPAL BENEFIT INS. SOLUTIONS3 | 355 SOUTH GRAND AVENUE, SUITE 2540 LOS ANGELES, CA 90071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.22% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET APARTMENT 1E CHICAGO, IL 60640 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $472 | $3K | 2.95% |
| WEST BENEFITS INS. MARKETING, INC.3 | PO BOX 3056 CORONA, CA 92879 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 2.68% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $210 | $1K | 1.41% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $523 | $142 | $665 | 0.68% |
| WENDY DAWN PACK3 Filed as: WENDY DAWN PACK AND OTHER AGENTS | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $503 | $10 | $513 | 0.53% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET APARTMENT 1E CHICAGO, IL 60640 | THE PAUL REVERE LIFE INSURANCE COMPANY | $350 | $38 | $388 | 7.96% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | THE PAUL REVERE LIFE INSURANCE COMPANY | $228 | $0 | $228 | 4.68% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | THE PAUL REVERE LIFE INSURANCE COMPANY | $59 | $0 | $59 | 1.21% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $58 | $0 | $58 | 1.19% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | THE PAUL REVERE LIFE INSURANCE COMPANY | $48 | $0 | $48 | 0.98% |
| DEIRDRE B HOEHN3 Filed as: DEIRDRE B. HOEHN | 30885 FRESH POND DRIVE OCEAN VIEW, DE 19970 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.10% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | THE PAUL REVERE LIFE INSURANCE COMPANY | $73 | $0 | $73 | 3.30% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET APARTMENT 1E CHICAGO, IL 60640 | THE PAUL REVERE LIFE INSURANCE COMPANY | $27 | $0 | $27 | 1.22% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 0.63% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | THE PAUL REVERE LIFE INSURANCE COMPANY | $9 | $0 | $9 | 0.41% |
| PRINCIPAL BENEFIT INS. SOLUTIONS3 | 355 SOUTH GRAND AVENUE, SUITE 2540 LOS ANGELES, CA 90071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $209 | $0 | $209 | 9.46% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $6 | $24 | 1.09% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.36% |
| WEST BENEFITS INSUR MKTG, INC.3 Filed as: WEST BENEFITS INSURANCE MARKETING | PO BOX 3056 CORONA, CA 92878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.32% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.23% |
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 | 541 | 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) | 541 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 990 | $6.3M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 990 | $6.1M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 990 | $6.1M |
| Life insurance(6 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 622 | $285K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 206 | $180K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 990 | $6.3M |
| Other(6 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 622 | $285K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 990 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.