| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $82K | $0 | $82K | 5.06% |
| CHARINA INIGO3 | 11517 CHADWICK ROAD CORONA, CA 92878 | AFLAC | $6K | $110 | $6K | 1.52% |
| CECILIA CALLEROS GOMEZ3 Filed as: CECILIA C. GOMEZ AND OTHER AGENTS | 328 NORTH CLINTON STREET ORANGE, CA 92867 | AFLAC | $1K | $127 | $1K | 0.34% |
| JOHNATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DRIVE CYPRESS, CA 90630 | AFLAC | $1K | $32 | $1K | 0.27% |
| MARIA R. QUINTANA3 | 911 SOUTH WEBSTER AVENUE APARTMENT 7 ANAHEIM, CA 92804 | AFLAC | $1K | $37 | $1K | 0.27% |
| NUBIA REBECA PINA3 | 8502 WEST WOODCOVE DRIVE SUITE 210 ANAHEIM, CA 92808 | AFLAC | $483 | $0 | $483 | 0.11% |
| REBECCA ORTIZ3 | 133337 SOUTH STREET, SUITE 656 CERRITOS, CA 90703 | AFLAC | $287 | $14 | $301 | 0.07% |
| MARK ROBERT MEYER3 | 13750 DARVALLE STREET CERRITOS, CA 90703 | AFLAC | $293 | $0 | $293 | 0.07% |
| CHARINA INIGO3 | 11517 CHADWICK ROAD CORONA, CA 92878 | AFLAC | $6K | $271 | $6K | 2.42% |
| JOHNATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DRIVE CYPRESS, CA 90630 | AFLAC | $1K | $87 | $1K | 0.44% |
| MARIA R. QUINTANA3 | 911 SOUTH WEBSTER AVENUE APARTMENT 7 ANAHEIM, CA 92804 | AFLAC | $1K | $65 | $1K | 0.42% |
| VERONICA RINCON3 | 2018 SOUTH WOODLAND PLAZA SANTA ANA, CA 92707 | AFLAC | $932 | $94 | $1K | 0.40% |
| MARK ROBERT MEYER3 | 13750 DARVALLE STREET CERRITOS, CA 90703 | AFLAC | $278 | $6 | $284 | 0.11% |
| DANIEL TYLER ADAMSON3 | 405 SOUTH HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $244 | $22 | $266 | 0.10% |
| RONALD B SALMON3 Filed as: RONALD B. SALMON AND OTHER AGENTS | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $120 | $0 | $120 | 0.05% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | HEALTH PLAN OF NEVADA | $11K | $3K | $14K | 5.66% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | AETNA | $9K | $0 | $9K | 5.03% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | UNKNOWN CORONA, CA 92883 | AETNA | $6K | $0 | $6K | 3.02% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $65 | $65 | 0.04% |
| CHARINA INIGO3 | 11517 CHADWICK ROAD CORONA, CA 92878 | AFLAC | $2K | $111 | $2K | 3.98% |
| AURELIO VELA3 | 7602 SORENSON AVENUE WHITTIER, CA 90606 | AFLAC | $1K | $96 | $1K | 2.48% |
| MARIA R. QUINTANA3 | 911 SOUTH WEBSTER AVENUE APARTMENT 7 ANAHEIM, CA 92804 | AFLAC | $306 | $26 | $332 | 0.73% |
| ANTAWONG THOMPSON3 Filed as: ANTAWONG L. THOMPSON | 2743 SOUTH SANDPIPER AVENUE ONTARIO, CA 91761 | AFLAC | $179 | $22 | $201 | 0.44% |
| THOMPSON & ASSOCIATES INSURANCE INC3 | 2743 SOUTH SANDPIPER AVENUE ONTARIO, CA 91761 | AFLAC | $15 | $0 | $15 | 0.03% |
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 | 672 | 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) | 672 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 235 | $2.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $184K |
| Vision(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA | 672 | $424K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $172K |
| Short-term disability(4 contracts, 2 carriers) | AFLAC | 672 | $900K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 235 | $2.1M |
| Other(4 contracts, 2 carriers) | AFLAC | 672 | $900K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 672 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.