| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPECTRUM RISK MGMT. AND INS. SVCS. | 74 DISCOVERY IRVINE, CA 92618 | KAISER FOUNDATION HEALTH PLAN INC | $32K | $0 | $32K | 4.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $4 | $3K | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $107 | $107 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $6K | $0 | $6K | 3.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $823 | $823 | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 4137 CLINTON, IA 52733 | UNITEDHEALTHCARE INSURANCE COMPANY | $724 | $0 | $724 | 1.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $2K | $12K | 17.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | BLUE CROSS BLUE SHIELD OF TEXAS | $2K | $105 | $2K | 4.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 17.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$2K | $4K | $2K | 6.14% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $177 | $0 | $177 | 2.70% |
| CHRISTOPHER L. TANG3 | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $156 | $0 | $156 | 2.38% |
| SCOTT W BLACKSHEAR AND OTHER AGENTS3 Filed as: SCOTT BLACKSHEAR AND OTHER AGENTS | 181 OLETA WAY SAINT AUGUSTINE, FL 32095 | AFLAC | $106 | $0 | $106 | 1.62% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 2144 DENA DRIVE CONCORD, CA 94519 | AFLAC | $67 | $0 | $67 | 1.02% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $61 | $0 | $61 | 0.93% |
| PAUL B KIRTON JR3 Filed as: PAUL B. KIRTON JR. | 5520 WILSHIRE BOULEVARD APARTMENT 727 LOS ANGELES, CA 90036 | AFLAC | $37 | $0 | $37 | 0.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $27 | $0 | $27 | 0.41% |
| GLEN DOUGLAS GABLE3 Filed as: GLEN DOUGLAS GABLE AND OTHER AGENTS | 3521 SOUTH CAMELLIA PLACE CHANDLER, AZ 85248 | AFLAC | $260 | $0 | $260 | 4.42% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $81 | $0 | $81 | 1.38% |
| LISA K ARELLANO3 Filed as: LISA K. ARELLANO | 2982 SAN FERNANDO STREET MINDEN, NV 89423 | AFLAC | $68 | $0 | $68 | 1.16% |
| SHARON I. MCDELVEY3 | 197 NORTH NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $64 | $0 | $64 | 1.09% |
| CHRISTOPHER L. TANG3 | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $39 | $0 | $39 | 0.66% |
| DANIEL ELDON SLY3 | 6885 WHISPERWIND DRIVE EASTVALE, CA 92882 | AFLAC | $36 | $0 | $36 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $30 | $0 | $30 | 0.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $515 | $266 | $781 | 22.48% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $153 | $0 | $153 | 5.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $116 | $0 | $116 | 4.48% |
| CHRISTOPHER L. TANG3 Filed as: CHRISTOPHER TANG AND OTHER AGENTS | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $63 | $0 | $63 | 2.44% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $57 | $0 | $57 | 2.20% |
| JACE G KUERSTEN3 Filed as: JACE G. KUERSTEN | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $39 | $0 | $39 | 1.51% |
| VICKI LYNN TIMMINS3 | 1053 BLOSSSOM HILL DRIVE CORONA, CA 92878 | AFLAC | $23 | $0 | $23 | 0.89% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $22 | $0 | $22 | 0.85% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPECTRUM RISK MGMT. AND INS. SVCS. | 74 DISCOVERY IRVINE, CA 92618 | AMERITAS LIFE INSURANCE CORPORATION | $225 | $0 | $225 | 9.99% |
| CHRISTOPHER L. TANG3 | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $19 | $0 | $19 | 3.25% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $13 | $0 | $13 | 2.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $13 | $0 | $13 | 2.22% |
| JACE G. KUERSTEN AND OTHER AGENTS3 | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $13 | $0 | $13 | 2.22% |
| VICKI LYNN TIMMINS3 | 1053 BLOSSSOM HILL DRIVE CORONA, CA 92878 | AFLAC | $12 | $0 | $12 | 2.05% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $10 | $0 | $10 | 1.71% |
| DANIEL ELDON SLY3 | 6885 WHISPERWIND DRIVE EASTVALE, CA 92882 | AFLAC | $5 | $0 | $5 | 0.85% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $14 | $0 | $14 | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $12 | $0 | $12 | 2.15% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $10 | $0 | $10 | 1.79% |
| JOHNATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $7 | $0 | $7 | 1.25% |
| LISA TAYLOR3 Filed as: LISA RENE TAYLOR | 3311 WEST LINCOLN AVENUE APARTMENT 5 ANAHEIM, CA 92801 | AFLAC | $4 | $0 | $4 | 0.72% |
| SAHAR QABAZARD3 Filed as: SAHAR QBABZARD AND OTHER AGENTS | 3756 DEER TRAIL COURT DANVILLE, CA 94506 | AFLAC | $4 | $0 | $4 | 0.72% |
| KRISTEN BRUNZELL3 Filed as: KRISTEN M. BRUNZELL | 340 EAST 1ST STREET, UNIT 3746 TUSTIN, CA 92781 | AFLAC | $2 | $0 | $2 | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $40 | $0 | $40 | 8.20% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $30 | $0 | $30 | 6.15% |
| JACE G KUERSTEN3 Filed as: JACE G. KUERSTEN | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $13 | $0 | $13 | 2.66% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $7 | $0 | $7 | 1.43% |
| JOHNATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $4 | $0 | $4 | 0.82% |
| VICKI LYNN TIMMINS3 | 1053 BLOSSSOM HILL DRIVE CORONA, CA 92878 | AFLAC | $3 | $0 | $3 | 0.61% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $27 | $0 | $27 | 12.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $19 | $0 | $19 | 8.52% |
| JACE G KUERSTEN3 Filed as: JACE G. KUERSTEN | 1574 SAN FERNANDO DRIVE CORONA, CA 92882 | AFLAC | $6 | $0 | $6 | 2.69% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $4 | $0 | $4 | 1.79% |
| JOHNATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $2 | $0 | $2 | 0.90% |
| PATRICIA ANN BOSCH3 | 6816 HOMAN COURT CHINO, CA 91710 | AFLAC | $1 | $0 | $1 | 0.45% |
| PHILLIP S GLEASON3 Filed as: PHILLIP S. GLEASON | 1234 NORTH LA BREA AVENUE APARTMENT 330 WEST HOLLYWOOD, CA 90038 | AFLAC | $1 | $0 | $1 | 0.45% |
| CHRISTOPHER L. TANG3 | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $12 | $0 | $12 | 5.43% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $3 | $0 | $3 | 1.36% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $2 | $0 | $2 | 0.90% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $2 | $0 | $2 | 0.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2 | $0 | $2 | 0.90% |
| TERRANCE M LUCZAJ Filed as: TERRANCE M. LUCZAJ AND OTHER AGENTS | 29 CRESTVIEW DRIVE RANCHO SANTA MARGARITA, CA 92688 | AFLAC | $2 | $0 | $2 | 0.90% |
| JOHNATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $1 | $0 | $1 | 0.45% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 2144 DENA DRIVE CONCORD, CA 94519 | AFLAC | $7 | $0 | $7 | 6.36% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $2 | $0 | $2 | 1.82% |
| BARRY MCPHERSON INC Filed as: BARRY MCPHERSON AND OTHER AGENTS | 2211 MICHELSON DRIVE, SUITE 1150 IRVINE, CA 92612 | AFLAC | $1 | $0 | $1 | 0.91% |
| SHARI BOYCE3 | 4953 SOUTH JORDAN AVENUE ONTARIO, CA 91762 | AFLAC | $3 | $0 | $3 | 4.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2 | $0 | $2 | 3.03% |
| NICKI LYN ALBRIGHT3 | 965 CATALINA AVENUE SEAL BEACH, CA 90740 | AFLAC | $1 | $0 | $1 | 1.52% |
| JOHNATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $1 | $0 | $1 | 1.52% |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(14 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 119 | $1.1M |
| Dental(12 contracts, 3 carriers) | DELTA DENTAL OF CALIFORNIA | 124 | $109K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 39 | $6K |
| Life insurance(11 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $85K |
| Short-term disability(11 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $85K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $67K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 119 | $1.0M |
| Other(11 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.