| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | KAISER FOUNDATION HEALTH PLAN INC | $41K | — | $41K | 5.81% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $68K | — | $68K | 10.00% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | $207K | — | $207K | 51.42% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $31K | — | $31K | 10.00% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | — | $23K | 10.00% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | VISION SERVICE PLAN | $4K | — | $4K | 2.07% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 10.00% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | DELTA DENTAL OF CALIFORNIA | $19K | — | $19K | 60.85% |
| CHERYL A STIFF3 | PO BOX 793 GAYLORD, MI 49734 | AFLAC | $843 | — | $843 | 6.00% |
| MIELKE INSURANCE INC3 | PO BOX 26 CHARLEVOIX, MI 49720 | AFLAC | $164 | — | $164 | 1.17% |
| KEVIN E GATLIN3 | PO BOX 402 MORAN, WY 83013 | AFLAC | $117 | — | $117 | 0.83% |
| BRADLEY J LOWRAN3 | 9553 E WALKABOUT LANE TRAVERSE CITY, MI 49684 | AFLAC | $108 | — | $108 | 0.77% |
| LINDA L WIKLE3 | 7174 DEEPWATER POINT RD WILLIAMSBURG, MI 49690 | AFLAC | $107 | — | $107 | 0.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SRVC INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $75 | — | $75 | 0.53% |
| THE HORTON GROUP3 Filed as: KRISTIN E HORTON | 6275 THEISEN ROAD ELMIRA, MI 49730 | AFLAC | $59 | — | $59 | 0.42% |
| DEBORAH L JONGES3 | P.O. BOX 31994 PALM BEACH GARDENS, FL 33420 | AFLAC | $49 | — | $49 | 0.35% |
| LYNNE M HARVEY3 | 307 S MAPLE AVE GAYLORD, MI 49735 | AFLAC | $39 | — | $39 | 0.28% |
| BENJAMIN HUNTER3 | 735 S GARFIELD AVE SUITE 203 TRAVERSE CITY, MI 49686 | AFLAC | $38 | — | $38 | 0.27% |
| DUANE E CORDES3 | P.O. BOX 455 HILLMAN, MI 49746 | AFLAC | $33 | — | $33 | 0.23% |
| NATALIE K DAVIS3 | 1753 SNOW OWL COURT GAYLORD, MI 49735 | AFLAC | $32 | — | $32 | 0.23% |
| LISA A NELSON3 | PO BOX 456 CADILLAC, MI 49601 | AFLAC | $29 | — | $29 | 0.21% |
| WENDY STOCK3 | 6829 FIRESTONE COURT GAYLORD, MI 49735 | AFLAC | $28 | — | $28 | 0.20% |
| AMY N GEHLHAUSEN3 | 2602 NEWTON STREET SUITE B JASPER, IN 47546 | AFLAC | $27 | — | $27 | 0.19% |
| JAYNE A STALLINGS3 | 8056 TIGER PALM WAY FT MYERS, FL 33966 | AFLAC | $27 | — | $27 | 0.19% |
| AMY N GEHLHAUSEN3 Filed as: AMY N GEHLAUSEN | 3115 HOWARD DR JASPER, IN 47546 | AFLAC | $27 | — | $27 | 0.19% |
| TRENTON FRANDSEN3 Filed as: TRENTON L FRANDSEN | 929 MEADOW LANE AVE CODY, WY 82414 | AFLAC | $24 | — | $24 | 0.17% |
| ERIC D WESTALL3 | 7015 GULF FWY STE 125 HOUSTON, TX 77087 | AFLAC | $23 | — | $23 | 0.16% |
| SHANNON DEON MERRITT3 Filed as: SHANNON D MERRITT | 4349 WEBB RD WOLVERINE, MI 49799 | AFLAC | $21 | — | $21 | 0.15% |
| JOHN P KOWN II3 | 1275 SHILOH ROAD NW SUITE 2260 KENNESAW, GA 30144 | AFLAC | $18 | — | $18 | 0.13% |
| J THESIS & ASSOCIATES INC.3 Filed as: J THESIS & ASSOCIATES INC | 2048 OVERLAND AVE STE 202 BILLINGS, MT 59102 | AFLAC | $16 | — | $16 | 0.11% |
| RONALD A DASHKOVITZ3 | 20 MILLPOND TRL SAGINAW, MI 48603 | AFLAC | $15 | — | $15 | 0.11% |
| JASON L GLICK3 | 7628 GRATIOT RD RM 101 SAGINAW, MI 48609 | AFLAC | $15 | — | $15 | 0.11% |
| DEXTER ANTONIO HARRIS3 | 100 GALLERIA PARKWAY STE 900 ATLANTA, GA 30339 | AFLAC | $13 | — | $13 | 0.09% |
| DOUGLAS E FOX3 Filed as: DOUGLAS EDWARD FOX | 735 S GARFIELD AVE STE 203 TRAVERSE CITY, MI 49686 | AFLAC | $12 | — | $12 | 0.09% |
| DAVID ANDREW PEPIN3 | 14301 N 87TH ST SUITE 313 SCOTTSDALE, AZ 85260 | AFLAC | $12 | — | $12 | 0.09% |
| MICHAEL A CUTAIA3 | 1225 NORTH LOOP W SUITE 420 HOUSTON, TX 77008 | AFLAC | $12 | — | $12 | 0.09% |
| SAMANTHA J AYBAR3 | 1736 MORNING SUN LANE NAPLES, FL 34119 | AFLAC | $11 | — | $11 | 0.08% |
| SAMANTHA J AYBAR3 | 1317 TRIANDRA LN STE 125 NAPLES, FL 34119 | AFLAC | $11 | — | $11 | 0.08% |
| DAVID C CLOUD JR3 | 1301 SHILOH ROAD NW SUITE 1020 KENNESAW, GA 30144 | AFLAC | $10 | — | $10 | 0.07% |
| ANDREW K GLAUB3 | 2150 ASSOCIATION DRIVE SUITE 150 OKEMOS, MI 48864 | AFLAC | $10 | — | $10 | 0.07% |
| AMY EVANS3 | 14358 MAGNOLIA BLVD APT 103 SHERMAN OAKS, CA 91423 | AFLAC | $8 | — | $8 | 0.06% |
| CHRIS A GEHLHAUSEN3 | 5401 VOGEL RD EVANSVILLE, IN 47715 | AFLAC | $6 | — | $6 | 0.04% |
| CHRIS A GEHLHAUSEN3 | 5401 VOGEL RD STE 410 EVANSVILLE, IN 47715 | AFLAC | $6 | — | $6 | 0.04% |
| WARREN H FRANK JR3 | 301 HUGH STREET EAST JORDAN, MI 49727 | AFLAC | $5 | — | $5 | 0.04% |
| JOHN D TYLER3 | 130 DUCK HAWK WAY MARIETTA, SC 29661 | AFLAC | $4 | — | $4 | 0.03% |
| HENRY J DOMBROSKI3 | 4339 MULLETT-BURT RD CHEBOYGAN, MI 49721 | AFLAC | $4 | — | $4 | 0.03% |
| ERIC D WESTALL3 | 4139 WILLOW HILL DR SEABROOK, TX 77586 | AFLAC | $3 | — | $3 | 0.02% |
| WILLIAM J CAMPBELL3 | PO BOX 66809 ST PETERSBURG BEACH, FL 33736 | AFLAC | $3 | — | $3 | 0.02% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BLVD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $3 | — | $3 | 0.02% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST FT LAUDERDALE, FL 33308 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL GRASS3 | 21707 KINGSLAND BLVD SUITE 105 KATY, TX 77450 | AFLAC | $2 | — | $2 | 0.01% |
| RICHARD J KUNZ3 | 351 CALIFORNIA ST STE 450 SAN FRANCISCO, CA 94104 | AFLAC | $1 | — | $1 | 0.01% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | DELTA DENTAL OF CALIFORNIA | $939 | — | $939 | 7.39% |
| AMY EVANS3 | 14358 MAGNOLIA BLVD APT 103 SHERMAN OAKS, CA 91423 | AFLAC | $164 | — | $164 | 2.53% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SRVC INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $117 | — | $117 | 1.80% |
| RENEE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD STE 740 SHERMAN OAKS, CA 91411 | AFLAC | $109 | — | $109 | 1.68% |
| MICHEAL JOHN LIZALDE3 | 1955 MINDA DR EUGENE, OR 97401 | AFLAC | $94 | — | $94 | 1.45% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST FT LAUDERDALE, FL 33308 | AFLAC | $72 | — | $72 | 1.11% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINANCIAL INS | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | AFLAC | $65 | — | $65 | 1.00% |
| CAMERON BELL3 | 2390 CRENSHAW BLVD SUITE 307 TORRANCE, CA 90501 | AFLAC | $54 | — | $54 | 0.83% |
| ALEXANDER G BAYER3 | 900 CAMINO REAL UNIT 201 REDONDO BEACH, CA 90277 | AFLAC | $30 | — | $30 | 0.46% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BLVD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $27 | — | $27 | 0.42% |
| KAREN LEE LINDSEY3 | 4465 NOTTINGHAM DR SANTA MARIA, CA 93455 | AFLAC | $24 | — | $24 | 0.37% |
| BRIAN G JAEGGI3 | 5112 TOPANGA CANYON BLVD WOODLAND HILLS, CA 91364 | AFLAC | $19 | — | $19 | 0.29% |
| YOLANDA JOY RICHMAN3 | 10000 NEVADA AVE CHATSWORTH, CA 91311 | AFLAC | $17 | — | $17 | 0.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H WILLIS | 1853 PENN ROYAL COURT MONUMENT, CO 80132 | AFLAC | $10 | — | $10 | 0.15% |
| CHRISTOPER EVANS3 | 14358 MAGNOLIA BLVD APT 103 SHERMAN OAKS, CA 91423 | AFLAC | $10 | — | $10 | 0.15% |
| RICHARD J KUNZ3 | 351 CALIFORNIA ST SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $9 | — | $9 | 0.14% |
| BARBARA ANN MCCLELLAND3 | 636A ORANGE GROVE AVENUE SOUTH PASADENA, CA 91030 | AFLAC | $4 | — | $4 | 0.06% |
| ADAM H MICHAELS3 | 12121 WILSHIRE BLVD STE 1000 LOS ANGELES, CA 90025 | AFLAC | $4 | — | $4 | 0.06% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD STE 300 VALENCIA, CA 91355 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $631 | — | $631 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH I EIN 95-4331852 CLAIM MED ADMINISTRATOR | Contract Administrator; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $606K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CLAIM ADMINISTRATOR | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $81K |
| CIGNA BEHAVORIAL HEALTH, INC. EIN 41-1648670 CLAIM ADMINISTRATOR | Participant communication; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $16K |
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 | 833 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 851 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 744 | $1.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 789 | $44K |
| Vision | VISION SERVICE PLAN | 800 | $192K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 833 | $680K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 833 | $226K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 833 | $311K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 744 | $1.1M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 744 | $1.2M |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 833 | $814K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 833 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.