| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GRP BNFTS & INS SRVS | 1800 QUAIL STREET, SUITE 110 SANTA ANA, CA 92799 | BLUE CROSS OF CALIFORNIA | $33K | $0 | $33K | 3.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $15K | $0 | $15K | 1.46% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | UNKNOWN BELLFLOWER, CA 90706 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $8K | $8K | 4.82% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, 2ND FLOOR HAUPPAUGE, NY 11788 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$5K | $0 | -$5K | -2.95% |
| CENTENNIAL GROUP BENEFITS3 Filed as: THE CENTENNIAL GROUP | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$5K | $0 | -$5K | -2.95% |
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GRP BNFTS & INS SRVS | PO BOX 26457 SANTA ANA, CA 92799 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $320 | $4K | 3.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 2.57% |
| JOSEPH J DERTHICK3 Filed as: JOSEPH J. DERTHICK | 15428 FLATBUSH AVENUE NORWALK, CA 90650 | AFLAC | $991 | $0 | $991 | 3.07% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $922 | $0 | $922 | 2.86% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK AND OTHER AGENTS | 1620 SOUTH DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $868 | $0 | $868 | 2.69% |
| H HOWARD THOMSON3 Filed as: H. HOWARD THOMSON | 14938 BARNWALL STREET LA MIRADA, CA 90638 | AFLAC | $518 | $0 | $518 | 1.61% |
| FRANCOISE YVONNE KORENBERG3 | 156 NORTH ORANGE DRIVE LOS ANGELES, CA 90036 | AFLAC | $457 | $0 | $457 | 1.42% |
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GRP BNFTS & INS SRVS | 1500 QUAIL STREET, SUITE 100 NEWPORT BEACH, CA 92660 | AFLAC | $188 | $0 | $188 | 0.58% |
| PATRICK ALVIN HOLLOWAY3 | 3006 SOUTH VERMONT AVENUE PBM 324 LOS ANGELES, CA 90007 | AFLAC | $158 | $0 | $158 | 0.49% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 111 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $158K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $158K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $190K |
| Short-term disability | AFLAC | 38 | $32K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 111 | $1.1M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.