| 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 | $46K | — | $46K | 6.86% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | INC. 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 2.17% |
| ALEX THOR FERNANDEZ DBA AXIS3 | INSURANCE AGENCY 18430 BROOKHURST ST #202B FOUNTAIN VALLEY, CA 927086757 | HEALTH NET | $11K | — | $11K | 6.80% |
| TABELLO INS SERVICES INC3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $7K | $881 | $8K | 11.62% |
| ALICIA CONTRERAS3 | 14229 STARBUCK ST WHITTIER, CA 90605 | AFLAC | $5K | $139 | $5K | 7.95% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $2K | $324 | $2K | 3.43% |
| ELENA MARIA VIERA3 | 232 JUNIPERO AVE APT E3 LONG BEACH, CA 90803 | AFLAC | $979 | $574 | $2K | 2.41% |
| AURELIO VELA INSURANCE SERVICES INC3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $731 | $348 | $1K | 1.67% |
| COLIN TIMOTHY KUROISHI3 | 13402 NEWLAND ST APT 1 GARDEN GROVE, CA 92844 | AFLAC | $261 | — | $261 | 0.40% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD SANTA ANA, CA 92704 | AFLAC | $180 | $49 | $229 | 0.35% |
| DANIEL G TABELLO3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $161 | — | $161 | 0.25% |
| YESSENIA NAVARRO3 | 13964 RAMHURST DR APT 21 LA MIRADA, CA 90638 | AFLAC | $135 | — | $135 | 0.21% |
| MADINA DAUDI3 | 27550 HILLCREST APT 4P MISSION VIEJO, CA 92691 | AFLAC | $89 | — | $89 | 0.14% |
| OLIVER SCHACK3 | 1561 E ORANGETHORPE AVE # 200 FULLERTON, CA 92831 | AFLAC | $36 | — | $36 | 0.06% |
| ANNEMARIE ROSE NICIEZA3 | 417 N CITRUS ST ORANGE, CA 92868 | AFLAC | $13 | — | $13 | 0.02% |
| ALEX FERNANDEZ D/B/A AXIS INSURANCE3 | AGENCY PO BOX 4064 HUNTINGTON BEACH, CA 926054064 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | — | $1K | 9.16% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 159 | $832K |
| Dental(3 contracts, 3 carriers) | HEALTH NET | 200 | $283K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 200 | $267K |
| Life insurance | AFLAC | 84 | $65K |
| Short-term disability | AFLAC | 84 | $65K |
| Other | AFLAC | 84 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.