| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROKERAGE CONCEPTS INC5 Filed as: BROKERAGE CONCEPTS, INC | 801 LAKEVIEW DR SUITE 301 BLUEBELL, PA 19422 | BLUE SHIELD OF CA | $0 | $160K | $160K | 18.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 45 E RIVER PARK PLACE WEST SUITE 60 FRESNO, CA 372091565 | BLUE SHIELD OF CA | $30K | $0 | $30K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES | TWO PIERCE PL ITASCA, IL 60143 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.14% |
| JEWEL LOPEZ3 Filed as: JEWEL L LOPEZ | 1330 COOPER AVE TURLOCK, CA 95380 | AFLAC | $4K | $112 | $4K | 6.36% |
| DERREK LYN KECK3 | 17809 COUNTRYSIDE CT SALINAS, CA 93907 | AFLAC | $1K | — | $1K | 1.71% |
| LINDA J. CASH3 Filed as: LINDA A HYMER | 3200 LOCKLEY CT MODESTO, CA 95350 | AFLAC | $692 | $0 | $692 | 1.08% |
| BOHANNON INSURANCE AGENCY, INC.3 Filed as: BOHANNON INS AGCY INC | 4317 N STAR WAY #A MODESTO, CA 95356 | AFLAC | $421 | $0 | $421 | 0.66% |
| MELODY B THOMPSON3 Filed as: MELODY P IRELAND | 5225 PENTECOST DR STE 24 MODESTO, CA 95356 | AFLAC | $313 | $0 | $313 | 0.49% |
| HENRY IRELAND3 Filed as: HENRY P IRELAND | 5225 PENTECOST DR STE 24 MODESTO, CA 95356 | AFLAC | $272 | $22 | $294 | 0.46% |
| BARRY A WHITE3 | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $210 | $0 | $210 | 0.33% |
| ANA PATRICIA ARRIAGA3 | 1509 W YOSEMITE AVE STE A1 MANTECA, CA 95337 | AFLAC | $162 | $22 | $184 | 0.29% |
| LES HEINSEN INS SERVICES INC3 | 193 BLUE RAVINE RD STE 140 FOLSOM, CA 95630 | AFLAC | $139 | $22 | $161 | 0.25% |
| PETER T ARNOLD3 | 12199 SILVER SPRINGS PL GRASS VALLEY, CA 95949 | AFLAC | $134 | $0 | $134 | 0.21% |
| DOUGLAS E FOX3 | 735 S GARGIELD AVE STE 203 TRAVERSE CITY, MI 49686 | AFLAC | $104 | $0 | $104 | 0.16% |
| BRANDON BENNETT3 Filed as: BRANDON CHAD BENNETT | PO BOX 1365 COTTONWOOD, CA 96022 | AFLAC | $35 | $0 | $35 | 0.05% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: BENEFIT & RISK MANAGEMENT SERVICES | 10860 GOLD CENTER DR #100 RANCHO CORDOVA, CA 95670 | AFLAC | $34 | $0 | $34 | 0.05% |
| FAUSTINO F RODRIGUEZ3 | 3020 BLUEWATER CT SAN JOSE, CA 95148 | AFLAC | $32 | $0 | $32 | 0.05% |
| VIRGIL LEE WHITE3 | 1123 SOQUEL AVE SANTA CRUZ, CA 95062 | AFLAC | $23 | $0 | $23 | 0.04% |
| DEANNA L SEVERN3 | 860 KNAPP ST YREKA, CA 96097 | AFLAC | $23 | $0 | $23 | 0.04% |
| THEODORE J CRANE3 | 2621 PRESCOTT RD SPC 250 MODESTO, CA 95350 | AFLAC | $17 | $0 | $17 | 0.03% |
| ALLISON FARRIS WENDELBERGER3 | 1839 YGNACIO VALLEY RD SUITE 393 WALNUT CREEK, CA 94598 | AFLAC | $9 | $0 | $9 | 0.01% |
| KANCHAN KALS3 | 20858 BLACK OAK DR PATTERSON, CA 95363 | AFLAC | $7 | $0 | $7 | 0.01% |
| TONIA L DESILVA3 | 1605 RICE AVE TURLOCK, CA 95382 | AFLAC | $7 | $0 | $7 | 0.01% |
| CALIFORNIA EAST BAY INS SERV INC3 Filed as: CALIFORNIA EASY BAY INS SERV INC | 5236 TAPESTRY CT FAIRFIELD, CA 94534 | AFLAC | $7 | $0 | $7 | 0.01% |
| BETH A. HESTER3 Filed as: BETH A HESTER | 1143 CHAMPAGNE LN MANTECA, CA 95337 | AFLAC | $2 | $0 | $2 | 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 | 601 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 601 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AFLAC | 123 | $64K |
| Vision | VISION SERVICE PLAN | 599 | $68K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 530 | $89K |
| Short-term disability(2 contracts, 2 carriers) | THE HARTFORD | 530 | $285K |
| Stop-loss / reinsurancereinsurance | BLUE SHIELD OF CA | 530 | $876K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 599 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.