| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEST BENEFITS INSURANCE MKTG., INC.3 Filed as: WEST BENEFITS INS. MARKETING, INC. | 655 VALLEYWOOD CIRCLE CORONA, CA 92879 | UNITEDHEALTHCARE INSURANCE COMPANY | $214K | $0 | $214K | 4.25% |
| WEST BENEFITS INSURANCE MKTG., INC.3 Filed as: WEST BENEFITS INS. MARKETING, INC. | PO BOX 3056 CORONA, CA 92878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15K | $0 | $15K | 7.99% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 3.99% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $689 | $3K | 1.37% |
| MJ INSURANCE3 Filed as: KPW, INC. AND VARIOUS AGENTS | 312 RAINBOW CIRCLE EL PASO, TX 79912 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $377 | $2K | 0.86% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $175 | $1K | 0.80% |
| RON ROSENSTEIN3 | 3711 NORTH STANTON STREET EL PASO, TX 79902 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $805 | $294 | $1K | 0.59% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET CHICAGO, IL 60640 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $532 | $69 | $601 | 0.32% |
| PRINCIPAL BENEFIT INS. SOLUTIONS3 Filed as: PRINCIPAL BENEFIT SOLUTIONS, LLC | 355 SOUTH GRAND AVENUE LOS ANGELES, CA 90071 | SIMNSA | $10K | $0 | $10K | 7.00% |
| WEST BENEFITS INSURANCE MKTG., INC.3 Filed as: WEST BENEFITS INS. MARKETING, INC. | PO BOX 3056 CORONA, CA 92878 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 5.64% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 5.21% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET APARTMENT 1E CHICAGO, IL 60640 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $242 | $2K | 2.00% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $861 | $295 | $1K | 1.38% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $423 | $91 | $514 | 0.61% |
| MJ INSURANCE3 Filed as: DEIDRE H. HOEHN AND VARIOUS AGENTS | 30885 FRESH POND DRIVE OCEAN VIEW, DE 19970 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $267 | $3 | $270 | 0.32% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $134 | $0 | $134 | 0.16% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | THE PAUL REVERE LIFE INSURANCE COMPANY | $83 | $0 | $83 | 3.22% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET APARTMENT 1E CHICAGO, IL 60640 | THE PAUL REVERE LIFE INSURANCE COMPANY | $45 | $4 | $49 | 1.90% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | THE PAUL REVERE LIFE INSURANCE COMPANY | $25 | $0 | $25 | 0.97% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 0.27% |
| TINA HERNANDEZ3 | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 0.27% |
| DEIDRE B HOEHN3 Filed as: DEIDRE H. HOEHN | 30885 FRESH POND DRIVE OCEAN VIEW, DE 19970 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.19% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 1301 DOVE STREET, SUITE 340 NEWPORT BEACH, CA 92660 | THE PAUL REVERE LIFE INSURANCE COMPANY | $46 | $0 | $46 | 2.04% |
| MARIA VERONICA JARQUE3 | 4744 NORTH PAULINA STREET CHICAGO, IL 60640 | THE PAUL REVERE LIFE INSURANCE COMPANY | $26 | $1 | $27 | 1.20% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13 | $0 | $13 | 0.58% |
| TINA HERNANDEZ | 11779 WEST COCOPAH STREET AVONDALE, AZ 85323 | THE PAUL REVERE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.35% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.04% |
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 | 479 | 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) | 479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 927 | $5.2M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 927 | $5.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 927 | $5.0M |
| Life insurance(4 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 543 | $274K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 187 | $187K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 927 | $5.2M |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 543 | $274K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 927 | — |
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.