| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 750 B STREET SUITE 2400 SAN DIEGO, CA 921018114 | HEALTH NET | $38K | — | $38K | 3.02% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 680 LANGSDORF DRIVE #100 FULLERTON, CA 92831 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $4K | $14K | 14.62% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES | 2400 E. KATELLA AVE., SUITE 1100 ANAHEIM, CA 928065980 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| JAMES P BOADA3 | 5700 E. FRANKLIN ROAD SUITE 110 NAMPA, ID 83687 | AFLAC | $4K | $94 | $4K | 5.80% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES | 2400 E. KATELLA AVE., SUITE 1100 ANAHEIM, CA 92806 | AFLAC | $1K | — | $1K | 1.78% |
| JAMES P BOADA3 Filed as: JAMES P. BOADA | 30 STONY POINT LAGUNA NIGUEL, CA 92677 | AFLAC | $758 | — | $758 | 1.16% |
| CHARLIE WOODWARD3 | 22842 WILLARD AVENUE LAKE FOREST, CA 92630 | AFLAC | $481 | — | $481 | 0.73% |
| PEGGY K SALMON3 Filed as: PEGGY SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $379 | — | $379 | 0.58% |
| JONATHAN ALI HAJIMOMEN3 | 1501 E. ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $352 | — | $352 | 0.54% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 117TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $259 | $32 | $291 | 0.44% |
| ANDREW R GRETHEL3 Filed as: ANDREW GRETHEL | 600 S. HIDDEN VALLEY ROAD #160 CARLSBAD, CA 92011 | AFLAC | $229 | — | $229 | 0.35% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $180 | — | $180 | 0.27% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 641 HIGUERA STREET SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $134 | — | $134 | 0.20% |
| DAVID A. HOWARD3 Filed as: DAVID HOWARD | 2230 SKYVIEW LANE APT. 143 COLORADO SPRINGS, CO 80904 | AFLAC | $122 | — | $122 | 0.19% |
| CESAR A TORRES3 Filed as: CESAR TORRES | 23511 ALISO CREEK ROAD APT. 59 ALISO VIEJO, CA 92656 | AFLAC | $115 | — | $115 | 0.18% |
| G SCOTT COOKE3 Filed as: SCOTT BLACKSHEAR | 3453 CATHRYN DRIVE COLUMBUS, GA 31906 | AFLAC | $105 | — | $105 | 0.16% |
| MOLLIE D PEARSON3 Filed as: MOLLIE PEARSON | 360 EAST FIRST STREET, #130 TUSTIN, CA 92780 | AFLAC | $98 | — | $98 | 0.15% |
| SUWAT ASSAWAMATIYANONT3 | 1800 NE 48TH COURT FT. LAUDERDALE, FL 33308 | AFLAC | $95 | — | $95 | 0.14% |
| VICTORIA K. HIRSCH-BOADA3 Filed as: VICTORIA HIRSCH-BOADA | 30 STONEY POINT LAGUNA NIGUEL, CA 92677 | AFLAC | $69 | — | $69 | 0.11% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $54 | — | $54 | 0.08% |
| MARIA CHRISTINA VALENCIA3 | 7707 E. VIEWRIM DRIVE ANAHEIM, CA 92808 | AFLAC | $32 | — | $32 | 0.05% |
| DANIEL G TABELLO3 Filed as: DANIEL G. TABELLO | 1461 SIERRA VISTA DRIVE LA HABRA, CA 90631 | AFLAC | $21 | — | $21 | 0.03% |
| RICARDO SERRANO3 | 2350 BURNHAM DRIVE TUSTIN, CA 92782 | AFLAC | $20 | — | $20 | 0.03% |
| EVERTON A. ROBINSON3 | 5491 FOX HILLS AVENUE BUENA PARK, CA 90621 | AFLAC | $8 | — | $8 | 0.01% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON INC. | 2211 MICHELSON DRIVE SUITE 1150 IRVINE, CA 92312 | AFLAC | $7 | — | $7 | 0.01% |
| HOWARD SETH KAMLET3 | 11070 KATY FWY APT. 1468 HOUSTON, TX 77043 | AFLAC | $6 | — | $6 | 0.01% |
| JAMES J GRETHEL3 Filed as: JAMES J. GRETHEL | 865 CEDAR DRIVE LOVELAND, OH 45140 | AFLAC | $5 | — | $5 | 0.01% |
| VANZANTEN INSURANCE SERVICES INC3 Filed as: VANZANTEN INSURANCE SERVICES INC. | 40152 STOWE ROAD TEMECULA, CA 92591 | AFLAC | $4 | — | $4 | 0.01% |
| DALE I DAVIS3 Filed as: DALE I. DAVIS | 350 E. SHORT STREET NUMBER 416 LEXINGTON, KY 40507 | AFLAC | $1 | — | $1 | 0.00% |
| SETH JAFFE3 | 4127 E. MASSACHUSETTS STREET LONG BEACH, CA 90814 | AFLAC | $1 | — | $1 | 0.00% |
| OWEN JOHNSTON3 | 796 N. HART STREET ORANGE, CA 92867 | AFLAC | $1 | — | $1 | 0.00% |
| AMANDA M GRIFFITH3 Filed as: AMANDA M. GRIFFITH | 11400 SE 8TH STREET #375 BELLEVUE, WA 98004 | AFLAC | $1 | — | $1 | 0.00% |
| KRISTIN BEAN3 | 8220 UNIVERSITY AVENUE SUITE 413 LA MESA, CA 91942 | AFLAC | $1 | — | $1 | 0.00% |
| IOANNIS T GRATSINOPOULOS3 Filed as: IOANNIS T. GRATSINOPOULOS | 3565 SUMMERLINN DRIVE WEST LINN, OR 97068 | 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 | 262 | 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) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 156 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 139 | $94K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 139 | $94K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $94K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $94K |
| Prescription drug | HEALTH NET | 156 | $1.3M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.