| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 94104 | MODA HEALTH | $6K | — | $6K | 5.00% |
| CHRISTINA D VINCENT3 Filed as: CHRISTINA VINCENT | 10809 GOLDSBOROUGH CIRCLE OAKDALE, CA 95361 | AFLAC | $3K | $115 | $3K | 4.23% |
| HENRY IRELAND3 | 5225 PETECOST DRIVE SUITE 24 MODESTO, CA 95356 | AFLAC | $2K | — | $2K | 2.37% |
| MELODY IRELAND3 | 5225 PETECOST DRIVE SUITE 24 MODESTO, CA 95356 | AFLAC | $1K | $12 | $1K | 1.59% |
| JEWEL LOPEZ3 | 1330 COOPER AVE TURLOCK, CA 95380 | AFLAC | $861 | $27 | $888 | 1.39% |
| JOHN PAUL WARNKE3 Filed as: JOHN WARNKE | 3401 PEGER ROAD SUITE A FAIRBANKS, AK 99709 | AFLAC | $836 | — | $836 | 1.31% |
| BRUCE W. COUGHLIN3 Filed as: BRUCE COUGHLIN | 7005 DEL RIO DRIVE MODESTO, CA 95356 | AFLAC | $409 | — | $409 | 0.64% |
| SANDRA L. GIRARD3 Filed as: SANDRA GIRARD | 1116 SONORA AVE MANTECA, CA 95337 | AFLAC | $297 | $36 | $333 | 0.52% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 7775 DUTRA BEND DRIVE SACRAMENTO, CA 95831 | AFLAC | $292 | $36 | $328 | 0.51% |
| ROBERT PONCINI3 | 390 ROMANO WAY OAKDALE, CA 95361 | AFLAC | $212 | — | $212 | 0.33% |
| ROMAN THOMAS SORIA3 Filed as: ROMAN SORIA | 2346 W TURNER ROAD LODI, CA 95242 | AFLAC | $208 | — | $208 | 0.33% |
| ANA ARRIAGA3 | 980 ARLINGTON CIRCLE WOODLAND, CA 95695 | AFLAC | $201 | — | $201 | 0.31% |
| SHANNON G AHIERS3 Filed as: SHANNON AHIERS | 3401 PEGER ROAD SUITE A FAIRBANKS, AK 99709 | AFLAC | $127 | — | $127 | 0.20% |
| MAYRA CUARENTA3 | 620 EDGEBROOK COURT MODESTO, CA 95354 | AFLAC | $126 | — | $126 | 0.20% |
| JEFF CLARK3 | 4215 BOULDER COURT GIG HARBOR, WA 98332 | AFLAC | $126 | — | $126 | 0.20% |
| LANCE WALUSKO3 | 1405 E ORANGEBURG AVE MODESTO, CA 95355 | AFLAC | $122 | — | $122 | 0.19% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO NAMBO | 2175 57TH AVE SACRAMENTO, CA 95822 | AFLAC | $107 | — | $107 | 0.17% |
| WALTER O. PECCORINI3 Filed as: WALTER PECCORINI | 708 W SWAIN ROAD SACREMENTO, CA 95207 | AFLAC | $96 | — | $96 | 0.15% |
| LESTER RAY BLACKSHEAR3 Filed as: LESTER BLACKSHEAR | 9192 SE 169TH COOK PLACE THE VILLAGES, FL 32162 | AFLAC | $82 | — | $82 | 0.13% |
| BARRY A WHITE3 Filed as: BARRY WHITE | 1899 WINDING WAY LINCOLN, CA 95648 | AFLAC | $77 | — | $77 | 0.12% |
| DOUGLAS FOX3 | 6836 THAYER LAKE DRIVE ALDEN, MI 49612 | AFLAC | $43 | — | $43 | 0.07% |
| MICHAEL RHODD3 | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $33 | — | $33 | 0.05% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $33 | — | $33 | 0.05% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTE FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $31 | — | $31 | 0.05% |
| JEANNETTE E FATHERREE3 Filed as: JEANNETTE DURRANI | 14835 N 1ST AVE PHOENIX, AZ 85023 | AFLAC | $27 | — | $27 | 0.04% |
| BRENDA MALDONADO3 | 1916 ST AUGUSTINE COURT MODESTO, CA 95358 | AFLAC | $19 | — | $19 | 0.03% |
| LINDA BAILEY3 | 6505 DEADERICK COURT ORANGEVALE, CA 95662 | AFLAC | $16 | — | $16 | 0.03% |
| RICARDO SEMERIA3 | 1828 MILPAS LANE MODESTO, CA 95355 | AFLAC | $16 | — | $16 | 0.03% |
| ZACHARY W TURNER3 Filed as: ZACHARY TURNER | 3404 MONTCLAIR CIRCLE MODESTO, CA 95350 | AFLAC | $10 | — | $10 | 0.02% |
| GUILLERMO H PALOMINO3 Filed as: GUILLERMO PALOMINO | 14224 N 26TH DRIVE PHOENIX, AZ 85023 | AFLAC | $10 | — | $10 | 0.02% |
| PETER T ARNOLD3 Filed as: PETER ARNOLD | 9318 LAGOON DRIVE RENO, NV 89506 | AFLAC | $10 | — | $10 | 0.02% |
| WILLIAM B STAPP3 Filed as: WILLIAM STAPP | 1672 MIDLAND STREET NORTH POLE, AK 99705 | AFLAC | $10 | — | $10 | 0.02% |
| DAVID L KUNTZMAN3 Filed as: DAVID KUNTZMAN | 2212 W STATE STREET BOX 266 ALLIANCE, OH 44601 | AFLAC | $9 | — | $9 | 0.01% |
| JONATHAN PAYNE3 | 3572 SHADOWTREE LANE CHICO, CA 95928 | AFLAC | $9 | — | $9 | 0.01% |
| AMY LUDWICK3 | 229 MCKAYS POINT PLACE WEST SACRAMENTO, CA 95605 | AFLAC | $8 | — | $8 | 0.01% |
| CHERI AGUIRRE3 | 21787 S OLIVE AVE RIPON, CA 95366 | AFLAC | $8 | — | $8 | 0.01% |
| ROBERT PILKENTON3 | 6643 FM 2187 ROAD SEALY, TX 77474 | AFLAC | $7 | — | $7 | 0.01% |
| LISA A PERRI3 Filed as: LISA HUTCHERSON | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $6 | — | $6 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING CO | 2800 W MARCH LANE SUITE 100 STOCKTON, CA 95219 | AFLAC | $6 | — | $6 | 0.01% |
| MARK TAYLOR AGENCY3 Filed as: MARK TAYLOR | 1424 CITRUS DRIVE MODESTO, CA 95350 | AFLAC | $6 | — | $6 | 0.01% |
| LAUREL NICOLE HARMS3 Filed as: LAUREL HARMS | 785 TURRINI DRIVE DANVILLE, CA 94526 | AFLAC | $5 | — | $5 | 0.01% |
| NATALIYA MILES3 | 5225 PETECOST DRIVE SUITE 20 MODESTO, CA 95356 | AFLAC | $5 | — | $5 | 0.01% |
| RONNIE N FURMAN3 Filed as: RONNIE FURMAN | 3025 N 26TH STREET FORT SMITH, AR 72904 | AFLAC | $4 | — | $4 | 0.01% |
| DAVID C CLOUD JR3 Filed as: DAVID CLOUD JR | 12 TRENT DRIVE SE ROME, GA 30161 | AFLAC | $4 | — | $4 | 0.01% |
| EDWARD M RYSKA3 Filed as: EDWARD RYSKA | 6010 ROBLAR ROAD PETALUMA, CA 94952 | AFLAC | $4 | — | $4 | 0.01% |
| NEAL E. DAILY3 Filed as: NEAL DAILY | 1852 11TH STREET 310 TRACY, CA 95376 | AFLAC | $3 | — | $3 | 0.00% |
| SYLVIA AMPER3 | P.O. BOX 577045 MODENSTO, CA 95357 | AFLAC | $3 | — | $3 | 0.00% |
| NICHOLAS VIGIL3 | 7808 E CYPRESS STREET SCOTTSDALE, AZ 85257 | AFLAC | $2 | — | $2 | 0.00% |
| MATTHEW NACHAZEL3 | 16473 BAYWOOD LANE GRANGER, IN 46530 | AFLAC | $1 | — | $1 | 0.00% |
| SALLY MEAD3 | 1535 FIANNA PLACE TERRANCE FORT SMITH, AR 72908 | AFLAC | $1 | — | $1 | 0.00% |
| SIERRA N KIRSHY3 Filed as: SIERRA KIRSHY | 348 DIAMOND OAKS ROAD ROSEVILLE, CA 95678 | AFLAC | $1 | — | $1 | 0.00% |
| SHAUNNA FERRENBURG3 | 1809 W 104TH AVE ANCHORAGE, AK 99515 | AFLAC | $1 | — | $1 | 0.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $633 | $5K | 10.48% |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 351 | $1.9M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 200 | $47K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 200 | $47K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 351 | $1.7M |
| Other(2 contracts, 2 carriers) | AFLAC | 200 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.