| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $69K | $739 | $69K | 7.05% |
| JACQUELYN E. K. HOLDER3 | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $6K | $93 | $6K | 8.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $5K | $0 | $5K | 7.88% |
| SIEMS INSURANCE SOLUTIONS INC3 Filed as: SIEMS INS SOL INC AND OTHER AGENTS | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $3K | $131 | $3K | 4.99% |
| TOAN HUU PHAM3 | 546 SOUTH HARBOR BOULEVARD SANTA ANA, CA 92704 | AFLAC | $2K | $0 | $2K | 3.21% |
| STEPHANIE MARIE DERAN3 | 1059 EAST BRADLEY AVENUE APARTMENT 102 EL CAJON, CA 92021 | AFLAC | $2K | $10 | $2K | 2.57% |
| JD HOLDER ENTERPRISES INC3 Filed as: JD HOLDER ENTERPRISES, INC. | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $575 | $36 | $611 | 0.91% |
| WHITNEY L MILLWOOD3 Filed as: WHITNEY L. MILLWOOD | 3944 MURPHY CANYON ROAD, SUITE C203 SAN DIEGO, CA 92123 | AFLAC | $595 | $3 | $598 | 0.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $130 | $0 | $130 | 4.07% |
| AMANDA PERRY3 | 4340 SAN ROBERTO AVENUE APARTMENT 2 ANCHORAGE, AK 99508 | AFLAC | $72 | $11 | $83 | 2.60% |
| CHRISTOPHER KANE3 | 3641 EAST KLATT ROAD ANCHORAGE, AK 99516 | AFLAC | $54 | $0 | $54 | 1.69% |
| SHAUNNA FERRENBURG3 | 1809 WEST 104TH AVENUE ANCHORAGE, AK 99515 | AFLAC | $50 | $2 | $52 | 1.63% |
| MJ INSURANCE3 Filed as: JACK D. HOLDER AND VARIOUS AGENTS | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $43 | $9 | $52 | 1.63% |
| JACQUELYN E. K. HOLDER3 | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $32 | $0 | $32 | 1.00% |
| GARY L. FERRENBURG3 | 406 WEST FIREWEED LANE, SUITE 200 ANCHORAGE, AK 99503 | AFLAC | $28 | $2 | $30 | 0.94% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 179 | $986K |
| Dental | BLUE CROSS OF CALIFORNIA | 179 | $986K |
| Vision | BLUE CROSS OF CALIFORNIA | 179 | $986K |
| Life insurance(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 179 | $1.1M |
| Short-term disability(2 contracts) | AFLAC | 65 | $70K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 179 | $986K |
| Other(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 179 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.