| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CALIFORNIA PHYSICIANS SERVICE | $18K | — | $18K | 3.21% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, INS. | 777 SOUTH FIGUEROA STREET, SUITE 2300 LOS ANGELES, CA 90017 | CALIFORNIA PHYSICIANS SERVICE | -$8K | — | -$8K | -1.32% |
| PEGGY K SALMON3 Filed as: PEGGY K. SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $5K | $343 | $5K | 9.60% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | AFLAC | $2K | — | $2K | 3.90% |
| RONALD B SALMON3 Filed as: RONALD B. SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $2K | — | $2K | 3.47% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $794 | $57 | $851 | 1.53% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 600 SOUTH HIDDEN VALLEY ROAD SUITE 150 CARLSBAD, CA 92011 | AFLAC | $131 | — | $131 | 0.24% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $122 | — | $122 | 0.22% |
| SCOTT W BLACKSHEAR AND OTHER AGENTS3 Filed as: SCOTT W. BLACKSHEAR AND OTHER AGENT | 3453 CATHRYN DRIVE COLUMBUS, GA 31906 | AFLAC | $72 | — | $72 | 0.13% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $699 | $4K | 11.66% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $296 | $2K | 11.43% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $807 | — | $807 | 6.95% |
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 | 131 | 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) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 100 | $576K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $54K |
| Vision | VISION SERVICE PLAN | 53 | $12K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 131 | $34K |
| Short-term disability | AFLAC | 57 | $56K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 100 | $576K |
| Other(2 contracts, 2 carriers) | AFLAC | 131 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.