| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | $0 | $32K | 3.31% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | $0 | $10K | 1.10% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 550 S HOPE STREET, SUITE 1000 LOS ANGELES, CA 90071 | CALIFORNIA PHYSICIANS SERVICE | $27K | $0 | $27K | 3.74% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $9K | $0 | $9K | 1.26% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $7K | $0 | $7K | 4.15% |
| DANONE SIMPSON INSURANCE SERVICES3 | DBA MONTAGE INSURANCE SERVICES 22110 CLARENDON ST., SUITE 210 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE CO. | $1K | $0 | $1K | 0.84% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET SUITE 600 IRVINE, CA 92614 | AFLAC | $3K | $0 | $3K | 6.51% |
| JONATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVE SUITE 200 FULLERTON, CA 92831 | AFLAC | $2K | $322 | $2K | 5.40% |
| DANIEL G TABELLO3 | 1461 SIERRA VISTA DR LA HABRA, CA 90631 | AFLAC | $1K | $494 | $2K | 4.11% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $1K | $145 | $1K | 3.73% |
| DANIEL G TABELLO3 | 1561 E ORANGETHORPE AVE SUITE 200 FULLERTON, CA 92831 | AFLAC | $1K | $0 | $1K | 3.50% |
| TOAN HUU PHAM3 | 11338 BARNWALL STREET NORWALK, CA 90650 | AFLAC | $1K | $11 | $1K | 2.76% |
| MATTHEW R PRINCE3 | 9600 WESTBOURNE CT CYPRESS, CA 90630 | AFLAC | $958 | $1 | $959 | 2.47% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE SUITE 200 FULLERTON, CA 92831 | AFLAC | $840 | $2 | $842 | 2.17% |
| TOAN HUU PHAM3 | 12127 CAMINO VALENCIA CERRITOS, CA 90703 | AFLAC | $337 | $58 | $395 | 1.02% |
| TOAN HUU PHAM3 | 18001 ARLINE AVE APT A ARTESIA, CA 90701 | AFLAC | $318 | $0 | $318 | 0.82% |
| SING CHUNG WANG3 | 1158 WHITEWATER DR FULLERTON, CA 92833 | AFLAC | $276 | $0 | $276 | 0.71% |
| MICHAEL P SCHNEIDER3 | 1501 E ORANGETHORPE AVE SUITE 200 FULLERTON, CA 92831 | AFLAC | $73 | $0 | $73 | 0.19% |
| MICHAEL P SCHNEIDER3 | 15171 NORMANDIE AVE IRVINE, CA 92604 | AFLAC | $7 | $0 | $7 | 0.02% |
| IOANNIS T GRATSINOPOULOS3 | 3565 SUMMERLINN DR WEST LINN, OR 97068 | AFLAC | $7 | $0 | $7 | 0.02% |
| OWEN JOHNSTON3 | 796 N HART STREET ORANGE, CA 92867 | AFLAC | $7 | $0 | $7 | 0.02% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 926147226 | VISION SERVICE PLAN | $2K | $0 | $2K | 8.57% |
| DANONE SIMPSON INSURANCE SERVICES3 | DBA MONTAGE INSURANCE SOLUTIONS 5550 TOPANGA CANYON BLVD., STE. 310 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $284 | $0 | $284 | 1.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.54% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SERVICES LLC | 22110 CLARENDON STREET, SUITE 201 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $613 | $0 | $613 | 2.46% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED O OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.58% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SERVICES LLC | 22110 CLARENDON STREET, SUITE 201 WOODLAND HILLS, CA 91367 | UNITED O OMAHA LIFE INSURANCE COMPANY | $335 | $0 | $335 | 2.42% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $878 | $0 | $878 | 7.58% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SERVICES LLC | 22110 CLARENDON STREET, SUITE 201 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $280 | $0 | $280 | 2.42% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 14.83% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $235 | $0 | $235 | 5.00% |
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 | 147 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 223 | $1.7M |
| Dental | AETNA LIFE INSURANCE CO. | 364 | $175K |
| Vision | VISION SERVICE PLAN | 149 | $28K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $12K |
| Long-term disability | UNITED O OMAHA LIFE INSURANCE COMPANY | 144 | $14K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 223 | $1.7M |
| Other(4 contracts, 4 carriers) | AFLAC | 147 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 364 | — |
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.