| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION AVENUE, SUITE 700 DENVER, CO 80237 | BLUE CROSS OF CALIFORNIA | $143K | $9K | $152K | 3.94% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET 52ND FLOOR LOS ANGELES, CA 90017 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $73 | $14K | 8.78% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.38% |
| MJ INSURANCE3 Filed as: BRENDA MATUTE AND VARIOUS AGENTS | 13000 DRONFIELD AVENUE APARTMENT 206 SYLMAR, CA 91342 | AFLAC | $6K | $221 | $6K | 7.62% |
| MICHELLE C. LEE3 Filed as: MICHELLE LEE | 1044 LOMA LISA LANE ARCADIA, CA 91006 | AFLAC | $2K | $44 | $2K | 2.09% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | AFLAC | $1K | $0 | $1K | 1.90% |
| SHARON S. WIENER3 Filed as: SHARON WEINER | 8833 PICKFORD STREET LOS ANGELES, CA 90035 | AFLAC | $1K | $0 | $1K | 1.50% |
| DENNY P. TWIGG3 Filed as: DENNY TWIGG | 24405 CHESTNUT STREET, SUITE 103 SANTA CLARITA, CA 91321 | AFLAC | $1K | $0 | $1K | 1.36% |
| SYLVIA CANTU3 | 10418 HIDDEN MOON DRIVE HOUSTON, TX 77064 | AFLAC | $542 | $0 | $542 | 0.72% |
| MICHAEL R. FISHER3 Filed as: MICHAEL FISHER | 50 WEST LEMON AVENUE, SUITE 2 MONROVIA, CA 91016 | AFLAC | $517 | $17 | $534 | 0.71% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET 52ND FLOOR LOS ANGELES, CA 90017 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $0 | $2K | 9.13% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $350 | $350 | 1.46% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET 52ND FLOOR LOS ANGELES, CA 90017 | SAFEGUARD HEALTH PLANS INC., A TEXAS CORPORATION | $957 | $0 | $957 | 9.04% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | SAFEGUARD HEALTH PLANS INC., A TEXAS CORPORATION | $0 | $152 | $152 | 1.44% |
| BRYAN LEE3 | 2664 DOROTHY STREET BELLMORE, NY 11710 | AFLAC | $733 | $80 | $813 | 11.95% |
| MICHELLE C. LEE3 Filed as: MICHELLE LEE | 1044 LOMA LISA LANE ARCADIA, CA 91006 | AFLAC | $284 | $11 | $295 | 4.33% |
| LOCKTON COMPANIES, LLC3 | 1185 AVENUE OF THE AMERICAS 20TH FLOOR NEW YORK, NY 10036 | AFLAC | $214 | $0 | $214 | 3.14% |
| T.J. BURKE CORP. AND OTHER AGENTS3 | 401 EAST 80TH STREET APARTMENT 6J NEW YORK, NY 10038 | AFLAC | $173 | $25 | $198 | 2.91% |
| JACQUES P DAVID CORPORATION3 Filed as: JACQUES P. DAVID CORPORATION | 35 PINELAWN ROAD, SUITE 190 MELVILLE, NY 11747 | AFLAC | $99 | $17 | $116 | 1.70% |
| SHARON S. WIENER3 Filed as: SHARON WEINER | 8833 PICKFORD STREET LOS ANGELES, CA 90035 | AFLAC | $79 | $0 | $79 | 1.16% |
| KEITH LEPACK3 | 1991 BROADWAY NEW YORK, NY 10075 | AFLAC | $46 | $0 | $46 | 0.68% |
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 | 413 | 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) | 413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 467 | $3.9M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 438 | $193K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 438 | $158K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 467 | $3.9M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 467 | $3.9M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 467 | $3.9M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 467 | $3.9M |
| Other(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 467 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.