| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE SUITE 500 SAN DIEGO, CA 92122 | CALIFORNIA PHYSICIANS' SERVICE | — | $110K | $110K | 3.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | — | $74K | $74K | 2.11% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | — | $24K | 3.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | $2 | $12K | 1.61% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE SUITE 500 SAN DIEGO, CA 92122 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $26K | $10K | $37K | 9.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 4.74% |
| ANNETTE L. BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $1K | — | $1K | 3.93% |
| JACOB BURNS INC.3 | 2905 MAGNOLIA AVENUE LONG BEACH, CA 90806 | AFLAC | $646 | — | $646 | 1.94% |
| MARSH & MCLENNAN AGENCY LLC3 | P.O. BOX 350 CONSHOHOCKEN, PA 19428 | AFLAC | $162 | — | $162 | 0.49% |
| RENEE COHN3 | 20350 VENTURA BLVD. SUITE 200 WOODLAND HILLS, CA 91364 | AFLAC | $157 | — | $157 | 0.47% |
| GEORGE E ARBID3 Filed as: GEORGE E. ARBID | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $142 | — | $142 | 0.43% |
| MARY LOU GRAHAM3 | 1747 OFELIA WAY OXNARD, CA 93030 | AFLAC | $125 | — | $125 | 0.38% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 711 S. OLIVE STREET APT. 314 LOS ANGELES, CA 90014 | AFLAC | $122 | — | $122 | 0.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 500 N. BRAND BLVD. SUITE 100 GLENDALE, CA 91203 | AFLAC | $89 | — | $89 | 0.27% |
| ANA MARIA BACKNER3 | 30 LA ENCINA NEWBURY PARK, CA 91320 | AFLAC | $73 | — | $73 | 0.22% |
| LAURA CORRAL3 | 1211 S. CATALINA STREET APT. 1 LOS ANGELES, CA 90006 | AFLAC | $69 | — | $69 | 0.21% |
| KAREN M HUGHES3 Filed as: KAREN M. HUGHES | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $65 | — | $65 | 0.20% |
| DAWN A CHRISTENSEN3 Filed as: DAWN A. CHRISTENSEN | 24516 APPLE STREET NEWHALL, CA 91321 | AFLAC | $59 | — | $59 | 0.18% |
| CORI CAMPBELL3 | 4518 186TH STREET APT. 203 REDONDO BEACH, CA 90278 | AFLAC | $54 | — | $54 | 0.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INSURANCE | SERVICES WEST INC. 8943 W. QUAIL AVENUE PEORIA, AZ 85382 | AFLAC | $50 | — | $50 | 0.15% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 14747 N. NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $46 | — | $46 | 0.14% |
| DEBORAH KIM3 Filed as: DEBORAH R. K. KIM | 3567 BROTHERS LANE SANTA CLARA, CA 95051 | AFLAC | $42 | — | $42 | 0.13% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $35 | — | $35 | 0.11% |
| HORACIO J. LANZAS3 | 7032 BAIRD AVENUE RESEDA, CA 91335 | AFLAC | $34 | — | $34 | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INSURANCE | SERVICES WEST INC. 801 S. FIGUEROA STREET, SUITE 700 LOS ANGELES, CA 90017 | AFLAC | $33 | — | $33 | 0.10% |
| DAVID BRYANT3 | 1925 CENTURY PARK E. SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $29 | — | $29 | 0.09% |
| RENE CASTRO3 | 5460 E. EL PARQUE STREET LONG BEACH, CA 90815 | AFLAC | $29 | — | $29 | 0.09% |
| BRIAN E KATZ3 Filed as: BRIAN E. KATZ | 1032 S. SIERRA BONITA AVENUE LOS ANGELES, CA 90019 | AFLAC | $26 | — | $26 | 0.08% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $26 | — | $26 | 0.08% |
| DE VITA B MCKENZIE3 Filed as: DE VITA B. MCKENZIE | 1139 IROLO STREET LOS ANGELES, CA 90006 | AFLAC | $20 | — | $20 | 0.06% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE SUITE 500 SAN DIEGO, CA 92122 | AFLAC | $20 | — | $20 | 0.06% |
| OLENA K SHEA3 Filed as: OLENA K. SHEA | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $11 | — | $11 | 0.03% |
| ANDREINI AND COMPANY3 | 220 W. 20TH AVENUE SAN MATEO, CA 94403 | AFLAC | $9 | — | $9 | 0.03% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $9 | — | $9 | 0.03% |
| GEOFFREY MALAIS3 | P.O. BOX 280717 NORTHRIDGE, CA 91328 | AFLAC | $8 | — | $8 | 0.02% |
| CHRISTOPHER HAGER3 | 44 COLONIAL DRIVE RANCHO MIRAGE, CA 92270 | AFLAC | $2 | — | $2 | 0.01% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE STREET TOLUCA LAKE, CA 91602 | AFLAC | $2 | — | $2 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H. WILLIS JR. | 1431 NE 55TH STREET FORT LAUDERDALE, FL 33334 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 321 N. CLARK STREET SUITE 615 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.00% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 W. MAPLE AVENUE BARRINGTON, IL 60010 | AFLAC | $1 | — | $1 | 0.00% |
| LARA K GRANDE3 Filed as: LARA K. GRANDE | 117 MORNING MIST LANE FRANKLIN, TN 37064 | AFLAC | $1 | — | $1 | 0.00% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M. MILLER | 149 MALIBU ROAD MOORESVILLE, NC 28117 | AFLAC | $1 | — | $1 | 0.00% |
| KEITH LEPACK3 | 1991 BROADWAY APT. 12B NEW YORK, NY 10023 | AFLAC | $404 | — | $404 | 3.26% |
| JAMES K FULATER3 Filed as: JAMES K. FULATER | 3052 34TH STREET APT. 2A ASTORIA, NY 11103 | AFLAC | $237 | — | $237 | 1.91% |
| JACOB BURNS INC.3 Filed as: JACOB M. BURNS | 2905 MAGNOLIA AVENUE LONG BEACH, CA 90806 | AFLAC | $170 | — | $170 | 1.37% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET SUITE 8C NEW YORK, NY 10005 | AFLAC | $153 | — | $153 | 1.23% |
| MARSH & MCLENNAN AGENCY LLC3 | P.O. BOX 350 SUITE 306 CONSHOHOCKEN, PA 19428 | AFLAC | $149 | — | $149 | 1.20% |
| MARILYN BARNAVE3 | 8320 141ST STREET APT. 5K JAMAICA, NY 11435 | AFLAC | $95 | — | $95 | 0.77% |
| JAMES K FULATER3 Filed as: JAMES K. FULATER | 9840 57TH AVENUE APT. 3M CORONA, NY 11368 | AFLAC | $42 | — | $42 | 0.34% |
| MARILYN BARNAVE3 | 9727 AVENUE L BROOKLYN, NY 11236 | AFLAC | $19 | — | $19 | 0.15% |
| MICHAEL BURACK3 | 46 THREEPENCE DRIVE MELVILLE, NY 11747 | AFLAC | $3 | — | $3 | 0.02% |
| STEPHEN WHITE3 Filed as: STEPHEN P. WHITE | 5 EMERALD LANE MONTEBELLO, NY 10901 | AFLAC | $2 | — | $2 | 0.02% |
| TREVOR FENNELL3 | 7 HIGHLAND LANE EAST HAMPTON, NY 11937 | AFLAC | $2 | — | $2 | 0.02% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORP | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $2 | — | $2 | 0.02% |
| JAMES A GREGORY3 Filed as: JAMES A. GREGORY | P.O. BOX 51 EAST BURKE, VT 05832 | AFLAC | $1 | — | $1 | 0.01% |
| MICHAEL G RYAN3 Filed as: MICHAEL G. RYAN | P.O. BOX 60 CHROMO, CO 81128 | AFLAC | $1 | — | $1 | 0.01% |
| FLOYD AMIDON3 Filed as: FLOYD A. AMIDON | 160 BENMONT AVENUE SUITE 203 BENNINGTON, VT 05201 | 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 | 380 | 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) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 308 | $4.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $389K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $389K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $389K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $389K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $389K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 308 | $4.2M |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 379 | $435K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 379 | — |
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.