| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL ST STE 110 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $53K | — | $53K | 4.31% |
| BEERE & PURVES INC3 | 1350 TREAT BLVD STE 470 WALNUT CREEK, CA 94596 | BLUE CROSS OF CALIFORNIA | — | $22K | $22K | 1.80% |
| JOHN M. GILMOUR, INC.3 Filed as: JOHN M GILMOUR, INC. | 300 WEST GLENOAKS BLVD SUITE 301 GLENDALE, CA 91202 | BLUE CROSS OF CALIFORNIA | $3 | — | $3 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | BLUE CROSS OF CALIFORNIA | $3 | — | $3 | 0.00% |
| ERICA GOLDEN3 Filed as: ERICA R GOLDEN | 800 WILSHIRE BLVD SUITE 200 LOS ANGELES, CA 90017 | AFLAC | $4K | $98 | $4K | 11.70% |
| VERONICA INCHAURREGUI3 | 8965 ALEXANDER AVE SOUTHGATE, CA 90280 | AFLAC | $573 | $28 | $601 | 1.88% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $355 | $42 | $397 | 1.24% |
| LINDA M NAPOLI3 | 5335 YARMOUTH AVE 106 ENCINO, CA 91316 | AFLAC | $298 | — | $298 | 0.93% |
| RHOEL T VALDEZ3 Filed as: RHOEL VALDEZ | 20016 BLYTHE STREET WINNETKA, CA 91306 | AFLAC | $292 | — | $292 | 0.91% |
| GREGOR KREMENLIEV3 | 2635 RYAN ST CONCORD, CA 94518 | AFLAC | $107 | — | $107 | 0.33% |
| ANNE STOCKWELL3 | 1640 N ALVARADO ST LOS ANGELES, CA 90026 | AFLAC | $51 | $7 | $58 | 0.18% |
| THEODORE C RAZATOS3 | 116 SURREY LN SAN RAFAEL, CA 94903 | AFLAC | $50 | — | $50 | 0.16% |
| STEVE D SERVI3 | 6127 S RAINBOW BLVD LAS VEGAS, NV 89118 | AFLAC | $39 | — | $39 | 0.12% |
| BALTOR INSURANCE SERVICES3 | 11 AIRPORT BLVD STE 105 SAN FRANCISCO, CA 94080 | AFLAC | $27 | — | $27 | 0.08% |
| COLLEEN ELIZABET MCLEAN3 | 3816 BEETHOVEN ST APT 203 LOS ANGELES, CA 90066 | AFLAC | $22 | — | $22 | 0.07% |
| JON P BATES JR3 | 440 REGENTS PARK DR VALLEJO, CA 94591 | AFLAC | $18 | — | $18 | 0.06% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $17 | — | $17 | 0.05% |
| ROVONE MARVELLE GRAHAM3 | 23972 OLD POMEGRANATE RD YORBA LINDA, CA 92887 | AFLAC | $17 | — | $17 | 0.05% |
| BRENT Y TANAMACHI3 | 2288 KENT SAN METEO, CA 94403 | AFLAC | $13 | — | $13 | 0.04% |
| MANA INSURANCE SOLUTIONS INC3 Filed as: MANA INSURANCE SOLUTIONS | PO BOX 930 MAKAWAO, HI 96768 | AFLAC | $9 | — | $9 | 0.03% |
| PATRICIA GAIL LEES3 | 6055 E WASHINGTON BLVD SUITE 210 COMMERCE, CA 90040 | AFLAC | $8 | — | $8 | 0.02% |
| DORA BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $4 | — | $4 | 0.01% |
| LAUREL NICOLE HARMS3 | 785 TURRINI DR DANVILLE, CA 94526 | AFLAC | $3 | — | $3 | 0.01% |
| BARRY MCPHERSON INC3 | 2211 MICHELSON DR STE 1150 IRVINE, CA 92612 | AFLAC | $3 | — | $3 | 0.01% |
| DALE I DAVIS3 | 1856 TRAVELLER RD LEXINGON, KY 40515 | AFLAC | $2 | — | $2 | 0.01% |
| OWEN JOHNSTON3 | 796 N HART ST ORANGE, CA 92867 | AFLAC | $2 | — | $2 | 0.01% |
| EDWARD M RYSKA3 | 6010 ROBLAR RD PETALUMA, CA 94952 | AFLAC | $2 | — | $2 | 0.01% |
| HENRY SAUCEDA3 | 2268 ALPHA CIR LAVERNE, CA 91750 | AFLAC | $1 | — | $1 | 0.00% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $1 | — | $1 | 0.00% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $1 | — | $1 | 0.00% |
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 | 143 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 143 | $1.2M |
| Dental | BLUE CROSS OF CALIFORNIA | 143 | $1.2M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 143 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 143 | $1.3M |
| Short-term disability | AFLAC | 28 | $32K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 143 | $1.2M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 143 | $1.2M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 143 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.