| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 E. UNION, SUITE 700 DENVER, CO 80237 | BLUE CROSS OF CALIFORNIA | $90K | $4K | $94K | 6.80% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 80 S. 8TH ST. SUITE 4628 MINNEAPOLIS, MN 55402 | BLUE CROSS OF CALIFORNIA | — | $25K | $25K | 1.79% |
| BENEFITS AMERICA INSURANCE SERVICES3 | LLC 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | -$45 | — | -$45 | -0.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S. FIGUEROA ST. 35TH FLOOR LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 5.59% |
| DANIEL TYLER ADAMSON3 | 405 X. HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 5.35% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE. 12TH FLOOR WOODLAND HILLS, CA 91367 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.75% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 1501 ORANGETHORPE SUITE 108 FULLERTON, CA 90620 | CONTINENTAL AMERICAN INSURANCE COMPANY | $768 | — | $768 | 0.90% |
| JANICE M ADAMSON3 Filed as: JANICE M. ADAMSON | 405 S. HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $752 | — | $752 | 0.88% |
| DANIEL TYLER ADAMSON3 | 2700 N. MAIN ST. SUITE 945 SANTA ANA, CA 92705 | CONTINENTAL AMERICAN INSURANCE COMPANY | $600 | — | $600 | 0.70% |
| JULIE L WOLD3 Filed as: JULIE L. WOLD | 7720 E. MOONRIDGE LANE ANAHEIM HILLS, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $355 | — | $355 | 0.42% |
| GINA L GAXIOLA3 Filed as: GINA L. GAXIOLA | 730 MANDEVILLA WAY CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $85 | — | $85 | 0.10% |
| ARTHUR LEYVAS3 | 495 E. RINCON ST. SUITE 212 CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $71 | — | $71 | 0.08% |
| FELIX CORTES3 | 810 25TH ST. SUITE 2409 OGDEN, UT 84401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.03% |
| MJ INSURANCE3 Filed as: CLAUDIA E. DONOFRIO | 11140 LOS ALAMITOS BLVD. SUITE 201 LOS ALAMITOS, CA 90720 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| DAWN T SUCHECKI3 Filed as: DAWN SUCHECKI | 225 S. WATER ST. SUITE I WILMINGTON, NC 28401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| JASON DAVIS INSURANCE SERVICES INC3 Filed as: JASON DAVIS INSURANCE SERVICES INC. | 10571 CALLE LEE SUITE 171 LOS ALAMITOS, CA 90720 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| KEN MAJOR3 | 30207 PIPERS LANE FARMINGTON HILLS, MI 48334 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| CASSANDRA GREEN3 | 10541 CALLE LEE SUITE 125 LOS ALAMITOS, CA 90720 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.00% |
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 | 290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 290 | $1.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 290 | $1.4M |
| Vision | BLUE CROSS OF CALIFORNIA | 290 | $1.4M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 290 | $1.4M |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 295 | $85K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 290 | $1.4M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 295 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.
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.