| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE #200 SANTA CRUZ, CA 95062 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $27K | $0 | $27K | 11.58% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE, SUITE 200 STREET 200 SANTA CRUZ, CA 95062 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 7.98% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | AFLAC | $2K | $0 | $2K | 6.62% |
| BRIAN W PATTEN3 Filed as: BRIAN PATTEN | 120 MARGUERITE DR STE 101 CRANBERRY, PA 16066 | AFLAC | $370 | $82 | $452 | 1.84% |
| BRENDAN W DEASY3 | 120 MARGUERITE DR STE 101 CRANBERRY, PA 16066 | AFLAC | $303 | $60 | $363 | 1.48% |
| AMANDA BATES3 Filed as: AMANDA M BATES | 534 W 7TH AVENUE W HOMESTEAD, PA 15120 | AFLAC | $290 | $41 | $331 | 1.35% |
| HENRY DUNN INC3 Filed as: HENRY J IRELAND | 5225 PENTECOST DR STE 24 MODESTO, CA 95356 | AFLAC | $292 | $0 | $292 | 1.19% |
| JEWEL LOPEZ3 Filed as: JEWEL L LOPEZ | 1330 COOPER AVE TURLOCK, CA 95380 | AFLAC | $266 | $0 | $266 | 1.08% |
| BETH A. HESTER3 Filed as: BETH A HEISTER | 1143 CHAMPAGNE LN MANTECA, CA 95337 | AFLAC | $210 | $44 | $254 | 1.03% |
| MELODY IRELAND3 | 5225 PENTECOST DR STE 24 MODESTO, CA 91103 | AFLAC | $168 | $0 | $168 | 0.68% |
| MELISSA L COLEMAN3 | 605 WINDING RIDGE LN ROCKWALL, TX 75032 | AFLAC | $86 | $41 | $127 | 0.52% |
| HECTOR CABRAL3 | 575 N SUMMIT AVE PASADENA, CA 91103 | AFLAC | $115 | $0 | $115 | 0.47% |
| ANA PATRICIA ARRIAGA3 | 980 ARLINGTON CIR WOODLAND, CA 95695 | AFLAC | $114 | $0 | $114 | 0.46% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO M NAMBO | 2175 57TH AVE SACRAMENTO, CA 95822 | AFLAC | $102 | $9 | $111 | 0.45% |
| INOCENCIA M. CRAWFORD3 Filed as: INOCENCIA M CRAWFORD | 3733 GIBSON RD APT 33 EL MONTE, CA 91731 | AFLAC | $90 | $8 | $98 | 0.40% |
| VICTOE NORDENFLYCHT DARBY3 | 2459 N BRIGHTON ST BURBANK, CA 91504 | AFLAC | $57 | $30 | $87 | 0.35% |
| HEATHER BARTLEY3 | 120 MARGUERITE DR STE 101 CRANBERRY TWP, PA 16066 | AFLAC | $71 | $0 | $71 | 0.29% |
| LANCE WALUSKO3 | 1405 E ORANGEBURG AVE MODESTO, CA 95355 | AFLAC | $44 | $9 | $53 | 0.22% |
| LIZETTE CABRAL3 | 575 N SUMMIT AVE PASADENA, CA 91103 | AFLAC | $33 | $14 | $47 | 0.19% |
| WALTER O. PECCORINI3 Filed as: WALTER O PECCORINI | 708 W SWAIN RD STE 205 STOCKTON, CA 95207 | AFLAC | $43 | $0 | $43 | 0.17% |
| PEDRO LOMBERT3 | PO BOX 1231 INGLEWOOD, CA 90308 | AFLAC | $42 | $0 | $42 | 0.17% |
| ROBERT E PONCINI3 | 390 ROMANO WAY OAKDALE, CA 95361 | AFLAC | $33 | $0 | $33 | 0.13% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $32 | $0 | $32 | 0.13% |
| BERT ELIZABE ANDERSON3 | 1012 11TH ST STE 205 MODESTO, CA 95354 | AFLAC | $32 | $0 | $32 | 0.13% |
| DEANNA L SEVERN3 | 860 KNAPP ST YREKA, CA 96097 | AFLAC | $23 | $0 | $23 | 0.09% |
| JOHN EDWARD SYLER JR3 | 3347 MCDOUGALD BLVD STOCKTON, CA 95206 | AFLAC | $21 | $0 | $21 | 0.09% |
| LAMBERT MONTALBO3 | 26197 MIRADA ST HIGHLAND, CA 92346 | AFLAC | $17 | $0 | $17 | 0.07% |
| BARRY A WHITE3 | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $14 | $0 | $14 | 0.06% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 3247 W MARCH LN STE 210 STOCKTON, CA 95219 | AFLAC | $13 | $0 | $13 | 0.05% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 734004 CHICAGO, IL 60673 | AFLAC | $9 | $0 | $9 | 0.04% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 316 BARBATO LN SACRAMENTO, CA 95814 | AFLAC | $9 | $0 | $9 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIR FIELD, CA 94534 | AFLAC | $9 | $0 | $9 | 0.04% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $5 | $0 | $5 | 0.02% |
| ROBERT HICKS INS SERVICES INC3 | 928 12TH ST STE 210 MODESTO, CA 95354 | AFLAC | $5 | $0 | $5 | 0.02% |
| JANICE MARIE SPENCER3 | 4975 W CANDLEWOOD LN POST FALLS, ID 83854 | AFLAC | $4 | $0 | $4 | 0.02% |
| NICHOLAS E VIGIL3 | 7808 E CYPRESS ST SCOTTSDALE, AZ 85257 | AFLAC | $2 | $0 | $2 | 0.01% |
| LAUREL NICOLE HARMS3 | 785 TURRINI DR DANVILLE, CA 94526 | AFLAC | $1 | $0 | $1 | 0.00% |
| TANJORE SPLAN3 Filed as: TANJORE E SPLAN | 2101 MAID MARIANE LN MODESTO, CA 95355 | AFLAC | $1 | $0 | $1 | 0.00% |
| EDWARD M RYSKA3 | 6010 ROBLAR RD PETALUMA, CA 94952 | AFLAC | $1 | $0 | $1 | 0.00% |
| GUILLERMO H PALOMINO3 | 2319 E EDNA AVE PHOENIX, AZ 85022 | AFLAC | $1 | $0 | $1 | 0.00% |
| LINDA BAILEY3 Filed as: LINDA G BAILEY | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $1 | $0 | $1 | 0.00% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $1 | $0 | $1 | 0.00% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN DANIEL PAYNE | 3572 SHADOWTREE LN CHICO, CA 95928 | AFLAC | $0 | $0 | $0 | 0.00% |
| LISA M HUTCHERSON3 | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $0 | $0 | $0 | 0.00% |
| ROBERT PILKENTON3 Filed as: ROBERT L PILKENTON | 6643 FM 2187 RD SEALY, TX 77474 | AFLAC | $0 | $0 | $0 | 0.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL DRIVE SUITE 200 SANTA CRUZ, CA 95062 | GERBER | $1K | $0 | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 N/A | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | — | $32K |
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 | 241 | 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) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $231K |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 241 | $62K |
| Vision | GERBER | 79 | $14K |
| Short-term disability | AFLAC | 71 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.