| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BARICH AND ASSOCIATES INSURANCE3 | MARKETING SERVICES 1819 W REDLANDS BLVD# 104 D REDLANDS, CA 92373 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $70K | — | $70K | 4.66% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | LLC 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $30K | $30K | 2.03% |
| DEBRA J SUMPTER3 | PO BOX 9081 SAN BERNARDINO, CA 92427 | AFLAC | $9K | $306 | $9K | 16.46% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $2K | $4 | $2K | 3.17% |
| DWAYNE R MARTINEZ3 | 32937 BONITA MESA ST TEMECULA, CA 92592 | AFLAC | $1K | $71 | $1K | 2.09% |
| JOSEPH HOFFMAN3 | 29110 TEMBUSO LAKE ELSINORE, CA 92530 | AFLAC | $571 | — | $571 | 1.03% |
| JAMIE AMSTUTZ3 | 3755 AVOCADO BLVD 180 LA MESA, CA 91941 | AFLAC | $324 | — | $324 | 0.58% |
| GUINETH ANN REED3 | 208 FULTON AVE ROCKPORT, TX 78382 | AFLAC | $253 | — | $253 | 0.46% |
| TERRANCE M LUCZAJ3 | 29 CRESTVIEW DR RANCHO SANTA MARGARITA, CA 92688 | AFLAC | $69 | — | $69 | 0.12% |
| SAHAR QABAZARD3 | 443 S MAPLE DR BEVERLY HILLS, CA 90212 | AFLAC | $46 | — | $46 | 0.08% |
| JOY E GUNDERSON3 | 2144 DENA DR CONCORD, CA 94519 | AFLAC | $21 | — | $21 | 0.04% |
| TOMMY C FLEESON3 | 3395 MICHELSON DR APT 5155 IRVINE, CA 92612 | AFLAC | $21 | — | $21 | 0.04% |
| JULIE L WOLD3 | 7720 E MOONRIDGE LN ANAHEIM, CA 92808 | AFLAC | $18 | — | $18 | 0.03% |
| ANDREW R GRETHEL3 | 11739 HICKORY RUN CT LOVELAND, OH 45140 | AFLAC | $15 | — | $15 | 0.03% |
| JAMES J GRETHEL3 | 865 CEDAR DR LOVELAND, OH 45140 | AFLAC | $6 | — | $6 | 0.01% |
| KERSTIN J VANZANTEN3 | 40152 STOWE RD TEMECULA, CA 92591 | AFLAC | $6 | — | $6 | 0.01% |
| RACHEL M GALVAN3 | 1340 W 31ST ST SAN BERNARDINO, CA 92405 | AFLAC | $1 | — | $1 | 0.00% |
| DEBRA J SUMPTER3 | PO BOX 9081 SAN BERNARDINO, CA 92427 | AFLAC | $7K | $158 | $8K | 14.14% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $2K | — | $2K | 2.93% |
| DWAYNE R MARTINEZ3 | 32937 BONITA MESA ST TEMECULA, CA 92592 | AFLAC | $880 | $37 | $917 | 1.71% |
| JOSEPH HOFFMAN3 | 29110 TEMBUSO LAKE ELSINORE, CA 92530 | AFLAC | $552 | — | $552 | 1.03% |
| GUINETH ANN REED3 | 208 FULTON AVE ROCKPORT, TX 78382 | AFLAC | $448 | — | $448 | 0.83% |
| CHRIS FREITAG3 | 432 N PENNSYLVANIA AVE GLENDORA, CA 91741 | AFLAC | $227 | — | $227 | 0.42% |
| JAMIE AMSTUTZ3 | 3755 AVOCADO BLVD 180 LA MESA, CA 91941 | AFLAC | $198 | — | $198 | 0.37% |
| SAHAR QABAZARD3 | 443 S MAPLE DR BEVERLY HILLS, CA 90212 | AFLAC | $84 | — | $84 | 0.16% |
| THE HORTON GROUP3 Filed as: VERNA M HORTON | 2536 FOREST LK SANTA ANA, CA 92705 | AFLAC | $46 | — | $46 | 0.09% |
| TERRANCE M LUCZAJ3 | 1052 S DEWCREST DR ANAHEIM HILLS, CA 92808 | AFLAC | $35 | — | $35 | 0.07% |
| JULIUS ROBERT BOTELHO3 | PO BOX 1675 INYOKERN, CA 93527 | AFLAC | $33 | — | $33 | 0.06% |
| GABRIEL R JAUREGUI3 | 7155 CEDAR CREEK RD CORONA, CA 92880 | AFLAC | $27 | — | $27 | 0.05% |
| JONATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DR CYPRESS, CA 90630 | AFLAC | $22 | — | $22 | 0.04% |
| CHRISTOPHER L. TANG3 Filed as: CHRISTOPHER L TANG | 15155 LEFFINGWELL RD WHITTIER, CA 90604 | AFLAC | $20 | — | $20 | 0.04% |
| JESSICA RENEE GREENE3 Filed as: JESSICA R GREENE | 714 WILLIAMS DR APT B HUNTINGTON BEACH, CA 92648 | AFLAC | $20 | — | $20 | 0.04% |
| DANIEL MARTIN BREDESON3 | 19043 META RD CORNELIUS, NC 28031 | AFLAC | $18 | — | $18 | 0.03% |
| HARRY H SONKE3 | 2258 BLACK OAK PL RIVERSIDE, CA 92506 | AFLAC | $18 | — | $18 | 0.03% |
| TOMMY C FLEESON3 | 3395 MICHELSON DR APT 5155 IRVINE, CA 92612 | AFLAC | $12 | — | $12 | 0.02% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $11 | — | $11 | 0.02% |
| JOY E GUNDERSON3 | 2144 DENA DR CONCORD, CA 94519 | AFLAC | $10 | — | $10 | 0.02% |
| MATTHEW D PAULUS3 | 100 TENNESSEE ST APT 1 REDLANDS, CA 92373 | AFLAC | $8 | — | $8 | 0.01% |
| SHANE M OWEN3 Filed as: SHANE CRAIG DAVISON | 3013 LARGE HOP LN ANTIOCH, TN 37013 | AFLAC | $8 | — | $8 | 0.01% |
| MARK J WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $6 | — | $6 | 0.01% |
| NANCY L BOTELHO3 | PO BOX 1675 INYOKERN, CA 93527 | AFLAC | $6 | — | $6 | 0.01% |
| COLLEEN M LAPRADE3 | 1053 HERMES AVE ENCINITAS, CA 92024 | AFLAC | $6 | — | $6 | 0.01% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $6 | — | $6 | 0.01% |
| GCG FINANCIAL LLC3 Filed as: TERRANCE H DICKERSON | PO BOX 8217 REDLANDS, CA 92375 | AFLAC | $4 | — | $4 | 0.01% |
| KEITH A LYNAM3 | 710 N EMMA ST CHRISTOPHER, IL 62822 | AFLAC | $4 | — | $4 | 0.01% |
| ANDREW R GRETHEL3 | 11739 HICKORY RUN CT LOVELAND, OH 45140 | AFLAC | $3 | — | $3 | 0.01% |
| BARRY MCPHERSON INC3 | 3928 IRON BARK WAY MCKINNEY, TX 75071 | AFLAC | $2 | — | $2 | 0.00% |
| DALE IRA DAVIS3 | 5892 CEDARCREEK LN LEXINGTON, KY 40515 | AFLAC | $1 | — | $1 | 0.00% |
| OWEN JOHNSTON3 | 1231 W 2ND ST SANTA ANA, CA 92703 | AFLAC | $1 | — | $1 | 0.00% |
| JEFFREY T JOHNSON3 | 30766 MAINMAST DR AGOURA HILLS, CA 91301 | AFLAC | $1 | — | $1 | 0.00% |
| LORI LAINE3 | 1218 N LINCOLN ST. REDLANDS, CA 92374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $774 | $2K | 7.14% |
| DEALER INSURANCE SERVICES, INC.3 Filed as: DEALER INSURANCE SERVICES INC | 23151 VERDUGO DR. STE. 111 LAGUNA HILLS, CA 92653 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $817 | — | $817 | 3.21% |
| HEIDI ANN ACUNA3 | 1536 IRVINE AVE NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $712 | — | $712 | 2.80% |
| RICHARD BLACKSTONE3 | 6374 CHAFFEE ST VENTURA, CA 93003 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $545 | — | $545 | 2.14% |
| SHADRACH LUCAS SALVATIERRA3 | 330 E WIER RD SAN BERNARDINO, CA 92408 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $438 | $3 | $441 | 1.73% |
| CLIENT BENEFIT INSURANCE SERVICES3 Filed as: CLIENT BENEFIT INSURANCE SERVICES I | 10769 WOODSIDE AVE SANTEE, CA 92071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $416 | — | $416 | 1.63% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | $138 | $368 | 1.45% |
| UZIEL RIVERA3 | 1267 SILVER TORCH DRIVE BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $183 | $9 | $192 | 0.75% |
| DEMOLYNEUX CORPORATION3 | 173A FLOWER STREET COSTA MESA, CA 92627 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $81 | $135 | 0.53% |
| JASON JONES3 | 5 VIA DE LA MESA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $17 | $71 | 0.28% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.07% |
| TERIE D BRADFORD3 | 16057 OAKLEY RD. RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.06% |
| BARBARA ELLEN SMITH3 | 4040 EAST PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| CONSUMER DRIVEN BENEFITS LLC3 | 1301 DOVE ST NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.01% |
| TINA HERNANDEZ3 | 11779 W COCOPAH ST AVONDALE, AZ 85323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 337 | $1.5M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 337 | $1.5M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 337 | $1.5M |
| Life insurance(3 contracts, 2 carriers) | AFLAC | 52 | $135K |
| Short-term disability(3 contracts, 2 carriers) | AFLAC | 52 | $135K |
| Other(3 contracts, 2 carriers) | AFLAC | 52 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 337 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.