| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN, SUITE 200 IRVINE, CA 92612 | CALIFORNIACHOICE | $62K | — | $62K | 6.55% |
| AURELIO VELA INSURANCE SERVICES INC3 Filed as: AURELIO VELO | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $2K | — | $2K | 13.34% |
| MITCHELL SOLOMON3 | 3404 ALPINE CORT ROCKLIN, CA 95765 | AFLAC | $739 | — | $739 | 4.75% |
| KRISTEN BRUNZELL3 Filed as: KRISTEN M. BRUNZELL | 17291 IRVINE BOULEVARD SUITE 385 TUSTIN, CA 92780 | AFLAC | $366 | — | $366 | 2.35% |
| MJ INSURANCE3 Filed as: JAMES SARANTIS AND VARIOUS AGENTS | 2251 DOUGLAS BOULEVARD, SUITE 110 ROSEVILLE, CA 95661 | AFLAC | $296 | — | $296 | 1.90% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO NAMBO | 2175 57TH AVENUE SACRAMENTO, CA 95822 | AFLAC | $294 | — | $294 | 1.89% |
| G SCOTT COOKE3 | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $124 | — | $124 | 0.80% |
| NICKI TURNER3 Filed as: NICKI LYN TURNER | 12720 BARBATA ROAD LA MIRADA, CA 90638 | AFLAC | $96 | — | $96 | 0.62% |
| DIANA BUTTS3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC. | $1K | — | $1K | 9.16% |
| MARIBETH TENNISON3 | 2950 AIRWAY AVENUE, SUITE A-13 COSTA MESA, CA 92626 | SAFEGUARD HEALTH PLANS, INC. | $1K | — | $1K | 7.33% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 109 | $939K |
| Dental | SAFEGUARD HEALTH PLANS, INC. | 51 | $15K |
| Vision | SAFEGUARD HEALTH PLANS, INC. | 51 | $15K |
| Life insurance | CALIFORNIACHOICE | 109 | $939K |
| Prescription drug | CALIFORNIACHOICE | 109 | $939K |
| Other(2 contracts, 2 carriers) | CALIFORNIACHOICE | 109 | $955K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.