| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE ZIFF AGENCY, LLC3 | 2118 60TH DRIVE EAST BRADENTON, FL 34203 | BLUE CROSS OF CALIFORNIA | $28K | $0 | $28K | 2.16% |
| RELATION INSURANCE INC3 Filed as: RELATIONS INS. SERVICES OF CA, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | BLUE CROSS OF CALIFORNIA | $18K | $0 | $18K | 1.36% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FINANCIAL SVCES. | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | BLUE CROSS OF CALIFORNIA | $7K | $0 | $7K | 0.54% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS. AGENCY INC. | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | BLUE CROSS OF CALIFORNIA | $7 | $0 | $7 | 0.00% |
| DKG INS & FINANCIAL SERV INC.3 Filed as: DKG INSURANCE & FINANCIAL SVCES. | UNKNOWN SAN JUAN CAPISTRANO, CA 92675 | DELTA DENTAL OF WASHINGTON | $3K | $0 | $3K | 2.30% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA, INC. | UNKNOWN SAN JUAN CAPISTRANO, CA 92675 | DELTA DENTAL OF WASHINGTON | $2K | $0 | $2K | 1.37% |
| ADAM CHARLES ZIFF3 | UNKNOWN SAN JUAN CAPISTRANO, CA 92675 | DELTA DENTAL OF WASHINGTON | $2K | $0 | $2K | 1.35% |
| THE ZIFF AGENCY, LLC3 | 2118 60TH DRIVE EAST BRADENTON, FL 34203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 7.57% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA, INC. | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 6.73% |
| DKG INSURANCE & FINANCIAL SERVICES3 Filed as: DKG INSURANCE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $866 | $0 | $866 | 1.89% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BOULEVARD IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$200 | $0 | -$200 | -0.44% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR PH IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$200 | $0 | -$200 | -0.44% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FINANCIAL SVCES. | 12404 PARK CENTRAL DRIVE, SUITE 400 DALLAS, TX 75251 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.80% |
| RELATION INSURANCE INC3 Filed as: RELATIONS INS. SERVICES OF CA, INC. | 620 WEST CROMELL AVENUE, SUITE 106 FRESNO, CA 93711 | VISION SERVICE PLAN | $655 | $0 | $655 | 2.08% |
| RELATION INSURANCE SERVICES OF CA3 | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 9.33% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $351 | $0 | $351 | 3.12% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 511398 LOS ANGELES, CA 90051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $151 | $0 | $151 | 1.34% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA., INC. | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 32.39% |
| STEVEN RAY GRIFFIN3 | 200 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $63 | $0 | $63 | 0.98% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 511398 LOS ANGELES, CA 90051 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.42% |
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 | 334 | 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) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 385 | $1.3M |
| Dental | DELTA DENTAL OF WASHINGTON | 440 | $140K |
| Vision | VISION SERVICE PLAN | 286 | $31K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 251 | $52K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 251 | $46K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 385 | $1.3M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 251 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.