| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD SUITE 100 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $87K | $816 | $88K | 4.75% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES, INC. | 1350 TREAT BLVD SUITE 470 WALNUT CREEK, CA 94597 | BLUE CROSS OF CALIFORNIA | — | $35K | $35K | 1.89% |
| ERICA GOLDEN3 Filed as: ERICA R. GOLDEN | 800 WILSHIRE BLVD SUITE 200 LOS ANGELES, CA 90017 | AFLAC | $1K | — | $1K | 6.31% |
| ALBERT PATRICK OMALLEY3 | 4171 SEA VIEW LN LOS ANGELES, CA 90065 | AFLAC | $1K | — | $1K | 6.26% |
| AMANDA VANESSA PETERSON3 | 11 JURI ST SAN FRANSISCO, CA 94110 | AFLAC | $993 | — | $993 | 5.33% |
| PATRICIA GAIL LEES3 | 6055 E WASHINGTON BLVD SUITE 210 COMMERCE, CA 90040 | AFLAC | $237 | — | $237 | 1.27% |
| DORA BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $215 | — | $215 | 1.15% |
| JOSHUA BALTOR3 Filed as: JOSHUA S BALTOR | 11 AIRPORT BLVD SUITE 105 SOUTH SAN FRANSISCO, CA 94080 | AFLAC | $171 | — | $171 | 0.92% |
| BANZAI INSURANCE SOLUTIONS INC3 Filed as: BANZAI INSURANCE SOLUTIONS, INC. | 9209 COLBERG DR AUSTIN, TX 78749 | AFLAC | $116 | — | $116 | 0.62% |
| GREGOR KREMENLIEV3 | 2635 RYAN RD CONCORD, CA 94518 | AFLAC | $107 | — | $107 | 0.57% |
| COLLEEN NORIKO JOHIRO3 | 14617 ESTELLA AVENUE GARDENA, CA 90248 | AFLAC | $56 | — | $56 | 0.30% |
| PATRICIA GAIL LEES3 | 6055 E WASHINGTON BLVD SUITE 955 COMMERCE, CA 90040 | AFLAC | $51 | — | $51 | 0.27% |
| LINDA M NAPOLI3 | 2881 NE 32ND ST APT 120 FT LAUDERDALE, FL 33306 | AFLAC | $46 | — | $46 | 0.25% |
| NEIL J. RECKON3 Filed as: NEIL J RECKON | 1824 CALLE CIERVOS SAN DIMAS, CA 91773 | AFLAC | $40 | — | $40 | 0.21% |
| STEVE D SERVI3 | 6421 CONGRESS AVE STE 100 BOCA RATON, FL 33487 | AFLAC | $39 | — | $39 | 0.21% |
| JON P BATES JR3 | 440 REGENTS PARK DR VALLEJO, CA 94591 | AFLAC | $18 | — | $18 | 0.10% |
| THEODORE C RAZATOS3 | 116 SURREY LN SAN RAFAEL, CA 94903 | AFLAC | $15 | — | $15 | 0.08% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $12 | — | $12 | 0.06% |
| RAVONE MARVELLE GRAHAM3 | 1020 VISTA DEL CERRO DR UNIT 205 CORONA, CA 92879 | AFLAC | $10 | — | $10 | 0.05% |
| STEVE D SERVI3 | 6127 S RAINBOW BLVD SUITE 110 LAS VEGAS, NV 89118 | AFLAC | $8 | — | $8 | 0.04% |
| RONALD I MARTINDALE3 | 1242 N SAN DIMAS CANYON RD SAN DIMAS, CA 91773 | AFLAC | $6 | — | $6 | 0.03% |
| BRENT Y TANAMACHI3 | 2288 KENT ST SAN MATEO, CA 94403 | AFLAC | $4 | — | $4 | 0.02% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $3 | — | $3 | 0.02% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON, INC. | 2211 MICHELSON DR STE 1150 IRVINE, CA 92612 | AFLAC | $3 | — | $3 | 0.02% |
| JOSHUA BALTOR3 Filed as: JOSHUA S BALTOR | 11 AIRPORT BLVD STE 105 SOUTH SAN FRANSISCO, CA 94080 | AFLAC | $2 | — | $2 | 0.01% |
| LAUREL NICOLE HARMS3 | 785 TURRINI DR DANVILLE, CA 94526 | AFLAC | $2 | — | $2 | 0.01% |
| EDWARD M RYSKA3 | 6010 ROBLAR RD PETALUMA, CA 94952 | AFLAC | $2 | — | $2 | 0.01% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $2 | — | $2 | 0.01% |
| DALE I DAVIS3 | 1856 TRAVELLER RD LEXINGTON, KY 40504 | AFLAC | $2 | — | $2 | 0.01% |
| OWEN JOHNSTON3 | 796 N HART ST ORANGE, CA 92867 | AFLAC | $1 | — | $1 | 0.01% |
| TERRANCE M LUCZAJ3 | 255 E RINCON ST STE 110 CORONA, CA 92879 | AFLAC | $1 | — | $1 | 0.01% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A BUZZALLO | 9018 BALBOA BLVD STE 254 NORTHRIDGE, CA 91325 | AFLAC | $1 | — | $1 | 0.01% |
| JOY E GUNDERSON3 | 4531 VALLECITO LN YORBA LINDA, CA 92886 | AFLAC | $1 | — | $1 | 0.01% |
| HENRY SAUCEDA3 | 2268 ALPHA CIR LA VERNE, CA 91750 | AFLAC | $1 | — | $1 | 0.01% |
| DALE I DAVIS3 | 350 E SHORT ST 416 LEXINGTON, KY 40507 | AFLAC | $1 | — | $1 | 0.01% |
| RONALD I MARTINDALE3 | 2220 E ROUTE 66 STE 215 GLENDORA, CA 91740 | AFLAC | $1 | — | $1 | 0.01% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 257 | $1.9M |
| Short-term disability | AFLAC | 25 | $19K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 257 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.