| 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 | $78K | $8K | $85K | 5.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $714 | $0 | $714 | 3.49% |
| JD HOLDER ENTERPRISES INC3 Filed as: JD HOLDER ENTERPRISES INC. | 8676 ELLSWORTH LANE SANTEE, CA 92071 | AFLAC | $371 | $0 | $371 | 1.82% |
| JACQUELYN E. K. HOLDER3 Filed as: JACQUELYN E. K. HOLDEER | 9625 MISSION GORGE ROAD SUITE B2 304 SANTEE, CA 92071 | AFLAC | $295 | $0 | $295 | 1.44% |
| STEPHANIE MARIE DERAN3 Filed as: STEPHANIE M. DERAN AND OTHER AGENTS | 1059 EAST BRADLEY AVENUE APARTMENT 102 EL CAJON, CA 92021 | AFLAC | $292 | $0 | $292 | 1.43% |
| JD HOLDER ENTERPRISES INC3 Filed as: JD HOLDER ENTERPRISES INC. | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $168 | $0 | $168 | 0.82% |
| DELMA M. CLOYD3 | 3944 MURPHY CANYON ROAD SUITE C203 SAN DIEGO, CA 92123 | AFLAC | $166 | $0 | $166 | 0.81% |
| HAKIM CROSBY3 | 3944 MURPHY CANYON ROAD, SUITE C203 SAN DIEGO, CA 92123 | AFLAC | $112 | $0 | $112 | 0.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY ROAD SUITE 200 SAN DIEGO, CA 92121 | MEDIEXCEL HEALTH PLAN | $853 | $0 | $853 | 5.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY ROAD SUITE 200 SAN DIEGO, CA 92121 | MAGELLAN HEALTH | $324 | $0 | $324 | 4.00% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 267 | $1.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 267 | $1.4M |
| Vision | BLUE CROSS OF CALIFORNIA | 267 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 267 | $1.5M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 267 | $1.4M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 346 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 346 | — |
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.