| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | UNITEDHEALTHCARE INSURANCE COMPANY | $60K | $0 | $60K | 5.61% |
| SHARON A MARTIN-TOUSSAINT3 Filed as: SHARON TOUSSAINT | 231 PRIMROSE AVENUE MOUNT VERNON, NY 10552 | AFLAC | $7K | $0 | $7K | 22.69% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $4K | $0 | $4K | 12.77% |
| IVAN M SERVAIS3 Filed as: IVAN SERVAIS | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $1K | $0 | $1K | 3.83% |
| ALAINE S. VANNESS3 Filed as: ALAINE VANESS | 1217 SOUTH SCHOOL STREET LODI, CA 95240 | AFLAC | $218 | $0 | $218 | 0.68% |
| DAVID B. KITCHEN3 Filed as: DAVID KITCHEN | 5230 HARTER LANE LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $126 | $0 | $126 | 0.40% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $59 | $0 | $59 | 0.19% |
| MJ INSURANCE3 Filed as: LES HEINSEN INS AND VARIOUS AGENTS | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $39 | $0 | $39 | 0.12% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | AMERITAS LIFE INSURANCE CORPORATION | $1K | $34 | $1K | 10.27% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.54% |
| IVAN M SERVAIS3 Filed as: IVAN SERVAIS | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $1K | $0 | $1K | 19.09% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $837 | $0 | $837 | 11.45% |
| SHARON A MARTIN-TOUSSAINT3 Filed as: SHARON TOUSSAINT | 231 PRIMROSE AVENUE MOUNT VERNON, NY 10552 | AFLAC | $303 | $0 | $303 | 4.15% |
| MARITZA SANTIAGO3 | 1330 KEARNEY AVENUE, 2ND FLOOR BRONX, NY 10465 | AFLAC | $80 | $0 | $80 | 1.09% |
| MJ INSURANCE3 Filed as: PERRY MEDINA AND VARIOUS AGENTS | 1128 WASHINGTON GREEN NEW WINDSOR, NY 12553 | AFLAC | $37 | $0 | $37 | 0.51% |
| ALAINE S. VANNESS3 Filed as: ALAINE VANNESS | 1217 SOUTH SCHOOL STREET LODI, CA 95240 | AFLAC | $34 | $0 | $34 | 0.47% |
| NICHOLAS SALERNO3 | 1366 MYRTLE AVENUE, APARTMENT 2 BROOKLYN, NY 11237 | AFLAC | $27 | $0 | $27 | 0.37% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 196 | $1.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 196 | $1.1M |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 176 | $13K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 184 | $12K |
| Short-term disability(2 contracts) | AFLAC | 16 | $39K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 196 | $1.1M |
| Other(3 contracts, 2 carriers) | AFLAC | 184 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.