| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALEX FERNANDEZ D/B/A AXIS INSURANCE3 Filed as: ALEX FERNANDEZ | PO BOX 4064 HUNTINGTON BEACH, CA 926054064 | KAISER FOUNDATION HEALTH PLAN INC | $41K | — | $41K | 6.46% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | INC. 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 2.12% |
| ALEX THOR FERNANDEZ DBA AXIS3 | INSURANCE AGENCY 18430 BROOKHURST ST #202B FOUNTAIN VALLEY, CA 927086757 | HEALTH NET | $8K | — | $8K | 6.77% |
| ALEX FERNANDEZ D/B/A AXIS INSURANCE3 | AGENCY PO BOX 4064 HUNTINGTON BEACH, CA 926054064 | METROPOLITAN LIFE INSURANCE COMPANY | $524 | — | $524 | 0.53% |
| ELENA MARIA VIERA3 | 232 JUNIPERO AVE APT E3 LONG BEACH, CA 90803 | AFLAC | $4K | — | $4K | 9.90% |
| DANIEL G TABELLO3 | 1561 E ORANGE THORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $3K | — | $3K | 6.59% |
| TABELLO INS SERVICES INC3 | 1561 E ORANGE THORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $2K | — | $2K | 5.34% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $2K | — | $2K | 4.23% |
| AURELIO VELA INSURANCE SERVICES INC3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $2K | — | $2K | 4.05% |
| AURELIO VELA3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $669 | — | $669 | 1.57% |
| TABELLO INS SERVICES INC3 | 1561 E ORANGERHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $446 | — | $446 | 1.04% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD SANTA ANA, CA 92704 | AFLAC | $144 | — | $144 | 0.34% |
| ALICIA CONTRERAS3 | 14229 STARBUCK ST WHITTIER, CA 90605 | AFLAC | $45 | — | $45 | 0.11% |
| MADINA DAUDI3 | 27550 HILLCREST APT 4P MISSION VIEJO, CA 92691 | AFLAC | $37 | — | $37 | 0.09% |
| COLIN TIMOTHY KUROISHI3 | 13402 NEWLAND ST APT 1 GARDEN GROVE, CA 92844 | AFLAC | $33 | — | $33 | 0.08% |
| ALEX FERNANDEZ D/B/A AXIS INSURANCE3 | AGENCY PO BOX 4064 HUNTINGTON BEACH, CA 926054064 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | — | $1K | 10.03% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 137 | $761K |
| Dental(3 contracts, 3 carriers) | HEALTH NET | 188 | $232K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 188 | $218K |
| Life insurance | AFLAC | 64 | $43K |
| Short-term disability | AFLAC | 64 | $43K |
| Other | AFLAC | 64 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.