| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | CIGNA HEALTHCARE OF CALIFORNIA | $48K | — | $48K | 0.93% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $28K | $11K | $39K | 14.03% |
| SETH JAFFE3 | 4127 E. MASSACHUSETTS ST LONG BEACH, CA 90814 | AFLAC | $6K | $4 | $6K | 4.36% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | AFLAC | $4K | — | $4K | 3.12% |
| H HOWARD THOMSON3 | 65 PINE AVE SUITE 102 LONG BEACH, CA 90802 | AFLAC | $3K | — | $3K | 2.45% |
| JOSEPH J DERTHICK3 | 15428 FLATBUSH AVE NORWALK, CA 90650 | AFLAC | $3K | — | $3K | 2.35% |
| SETH JAFFE3 | 4127 E MASSACHUSETTS ST LONG BEACH, CA 90814 | AFLAC | $1K | $450 | $2K | 1.41% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $1K | — | $1K | 0.93% |
| PATRICIA GAIL LEES3 | 6055 E WASHINGTON BLVD SUITE 955 COMMERCE, CA 90040 | AFLAC | $1K | $130 | $1K | 0.84% |
| DAVID J REESOR3 | 2001 E FINANCIAL WAY STE 201 GLENDORA, CA 91741 | AFLAC | $1K | — | $1K | 0.80% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST FT LAUDERDALE, FL 33308 | AFLAC | $740 | — | $740 | 0.54% |
| PATRICIA D SLEDGE3 | 25586 18TH ST SAN BERNARDINO, CA 92404 | AFLAC | $595 | — | $595 | 0.43% |
| VALERIE LYNN VEGA3 | 4127 E MASSACHUSETTS ST LONG BEACH, CA 90814 | AFLAC | $269 | $201 | $470 | 0.34% |
| KAYLA MULLIGAN3 | 10523 VALPARAISO ST LOS ANGELES, CA 90034 | AFLAC | $293 | — | $293 | 0.21% |
| SETH JAFFE3 | 4127 E MASSACHUSETTS ST LONG BEACH, CA 90814 | AFLAC | $231 | — | $231 | 0.17% |
| RAVONE MARVELLE GRAHAM3 | 4621 BRIARHILL DR YORBA LINDA, CA 92886 | AFLAC | $178 | — | $178 | 0.13% |
| KATHLEEN S HANSON3 | 2581 HILLCREST ST SIGNAL HILL, CA 90755 | AFLAC | $165 | — | $165 | 0.12% |
| ALEJANDRO ORANTES3 | PO BOX 243 MONTEBELLO, CA 90640 | AFLAC | $110 | — | $110 | 0.08% |
| BARRY MCPHERSON INC3 | 2211 MICHELSON DR SUITE 1150 IRVINE, CA 92612 | AFLAC | $91 | — | $91 | 0.07% |
| KRISTOPHER KEAHIOLALO3 | 11835 W OLYMPIC BLVD STE 795 LOS ANGELES, CA 90064 | AFLAC | $81 | — | $81 | 0.06% |
| DE VITA B MCKENZIE3 Filed as: DE VITA B MCKEZIE | 110 SE 6TH ST STE 1700 FT LAUDERDALE, FL 33301 | AFLAC | $56 | — | $56 | 0.04% |
| LATISHA DENISE BROOKS3 | 10541 CALLE LEE 125 LOS ALAMITOS, CA 90720 | AFLAC | $43 | — | $43 | 0.03% |
| BETTY MURDOCK3 | 7216 TESSERA PKWY LAGO VISTA, TX 78645 | AFLAC | $37 | — | $37 | 0.03% |
| KAYLA MULLIGAN3 | 825 LINDA FLORA DR LOS ANGELES, CA 90049 | AFLAC | $35 | — | $35 | 0.03% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $34 | — | $34 | 0.02% |
| ANDREA M MACIAS3 | 7216 TESSERA PKWY LAGO VISTA, TX 78645 | AFLAC | $28 | — | $28 | 0.02% |
| KRISTEN NICOLE GLENN3 | 1604 VIA TULIPAN SAN CLEMENTE, CA 92673 | AFLAC | $20 | — | $20 | 0.01% |
| OWEN JOHNSTON3 | 796 N HART ST ORANGE, CA 92867 | AFLAC | $17 | — | $17 | 0.01% |
| DALE I DAVIS3 | 350 E SHORT ST NUMBER 416 LEXINGTON, KY 40507 | AFLAC | $16 | — | $16 | 0.01% |
| RASA REYNOLDS3 | 6716 CLYBOURN AVE UNIT 201 NORTH HOLLYWOOD, CA 91606 | AFLAC | $14 | — | $14 | 0.01% |
| JAMES P BOADA3 | 5700 E FRANKLIN RD STE 110 NAMPA, ID 83687 | AFLAC | $13 | — | $13 | 0.01% |
| LATISHA DENISE BROOKS3 | 10541 CALLE LEE STE 125 LOS ALAMITOS, CA 90720 | AFLAC | $11 | — | $11 | 0.01% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $9 | — | $9 | 0.01% |
| SHAWN M GLENN3 | 1604 VIA TULIPAN SAN CLEMENTE, CA 92673 | AFLAC | $7 | — | $7 | 0.01% |
| OSCAR FREGOSO3 | 340 E 2ND ST STE 310 LOS ANGELES, CA 90012 | AFLAC | $7 | — | $7 | 0.01% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $7 | — | $7 | 0.01% |
| PEGGY K SALMON3 | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $5 | — | $5 | 0.00% |
| STEVEN R HANSON3 | 340 E 2ND STREET STE 310 LOS ANGELES, CA 90012 | AFLAC | $4 | — | $4 | 0.00% |
| ACEVES INSURANCE SERVICES INC.3 Filed as: ACEVES INSURANCE SERVICES INC | 9959 BROOKSHIRE AVE DOWNEY, CA 90240 | AFLAC | $3 | — | $3 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 28202 CABOT RD STE 600 LAGUNA NIGUEL, CA 92677 | AFLAC | $3 | — | $3 | 0.00% |
| ANDREW R GRETHEL3 | 600 S HIDDEN VALLEY RD #150 CARLSBAD, CA 92011 | AFLAC | $3 | — | $3 | 0.00% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE RIVERSIDE, CA 92509 | AFLAC | $3 | — | $3 | 0.00% |
| BETTY MURDOCK3 | 2980 FLORINE AVE RIVERSIDE, CA 92509 | AFLAC | $1 | — | $1 | 0.00% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BLVD STE 254 NORTHRIDE, CA 91325 | AFLAC | $1 | — | $1 | 0.00% |
| HENRY SAUCEDA3 | 2268 ALPHA CIR LA VERNE, CA 91750 | AFLAC | $1 | — | $1 | 0.00% |
| IOANNIS T GRATSINOPOULOS3 | 3565 SUMMERLINN DR WEST LINN, OR 97068 | AFLAC | $1 | — | $1 | 0.00% |
| KRISTIN BEAN3 | 8220 UNIVERSITY AVE STE 413 LA MESSA, CA 91942 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 12121 WILSHIRE BLVD LOS ANGELES, CA 90025 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R FISHER | 3201 WILSHIRE BLVD STE 102 SANTA MONICA, CA 90403 | AFLAC | $1 | — | $1 | 0.00% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | VISION SERVICE PLAN | $8K | — | $8K | 9.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIM ADMIN MED & RX | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $637K |
| PRUDENTIAL EIN 22-1211670 CLAIM ADMIN EAP | Claims processing; Contract Administrator; Participant communication; Direct payment from the plan Service code 12 | — | $16 |
| CIGNA | Named fiduciary; Direct payment from the plan; Participant communication; Other services; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing Service code 12 | — | $0 |
| COMPSYCH EIN 35-3739783 CLAIM ADMIN EAP | Contract Administrator; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
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 | 727 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 730 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 1,404 | $6.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,404 | $1.5M |
| Vision | VISION SERVICE PLAN | 457 | $91K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 753 | $276K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 753 | $276K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,404 | $1.5M |
| Other | AFLAC | 231 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,404 | — |
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."
No prospect flags tripped on this filing.