| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INSURANCE | SERVICES, LLC 1920 MAIN ST., SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $48K | $6 | $48K | 4.36% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC. | $37 | — | $37 | 0.00% |
| SULLIVANCURTISMONROE INS. SVCS.3 | 550 S. HOPE STREET SUITE 1000 LOS ANGELES, CA 90071 | CALIFORNIA PHYSICIANS' SERVICE | $43K | — | $43K | 4.09% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | SERVICES LLC 1920 MAIN ST., SUITE 600 IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $9K | — | $9K | 4.57% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE CO. | $742 | — | $742 | 0.39% |
| TABELLO INS SERVICES INC3 Filed as: TABELLO INS. SERVICES INC. | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $2K | $11 | $2K | 3.55% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $2K | $125 | $2K | 3.40% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS LLC | 22110 CLAREMONT ST. SUITE 201 WOODLAND HILLS, CA 91367 | AFLAC | $2K | — | $2K | 3.34% |
| TOAN HUU PHAM3 | 546 S. HARBOR BLVD. SANTA ANA, CA 92704 | AFLAC | $1K | $276 | $1K | 2.47% |
| DANIEL G TABELLO3 Filed as: DANIEL G. TABELLO | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $978 | $259 | $1K | 2.10% |
| STACY LENAE KINOSHITA3 | 1561 E. ORANGETHORPE AVE. SUITE 200 FULLERTON, CA 92831 | AFLAC | $737 | $44 | $781 | 1.33% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | LLC 1920 MAIN ST., SUITE 600 IRVINE, CA 92614 | AFLAC | $586 | — | $586 | 1.00% |
| WESLEY SANCHEZ3 | 16824 JANINE DR. WHITTIER, CA 90603 | AFLAC | $290 | $164 | $454 | 0.77% |
| G SCOTT COOKE3 Filed as: G. SCOTT COOKE | 2832 NE 17TH AVE. WILTON MANORS, FL 33334 | AFLAC | $397 | — | $397 | 0.67% |
| MARIANO S. SOMERA III3 | 3364 AMY DR. CORONA, CA 92882 | AFLAC | $178 | — | $178 | 0.30% |
| IOANNIS T GRATSINOPOULOS3 Filed as: IOANNIS T. GRATSINOPOULOS | 3565 SUMMERLINN DR. WEST LINN, OR 97068 | AFLAC | $32 | — | $32 | 0.05% |
| OWEN JOHNSTON3 | 796 N. HART ST. ORANGE, CA 92867 | AFLAC | $32 | — | $32 | 0.05% |
| SHAHID ZIA KHAWAJA3 | 436 BLUE JAY DR. BREA, CA 92823 | AFLAC | $30 | — | $30 | 0.05% |
| MICHAEL P SCHNEIDER3 Filed as: MICHAEL P. SCHNEIDER | 1201 FAIRHAVEN AVE. APT. 11M SANTA ANA, CA 92705 | AFLAC | $14 | — | $14 | 0.02% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | LLC 550 S. HOPE ST., SUITE 1000 LOS ANGELES, CA 90071 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.12% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 31 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $655 | $655 | 2.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $258 | — | $258 | 0.88% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INSURANCE | SERVICES, LLC 550 S. HOPE ST., SUITE 1000 LOS ANGELES, CA 900712637 | VISION SERVICE PLAN | $1K | — | $1K | 3.92% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE | SERVICES LLC 5550 TOP CAYON BLVD., SUITE 310 WOODLAND HILLS, CA 913676406 | VISION SERVICE PLAN | $248 | — | $248 | 0.88% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE | INSURANCE SERVICES LLC 550 S. HOPE ST., SUITE 1000 LOS ANGELES, CA 90071 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 9.12% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 31 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $303 | $303 | 2.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $125 | — | $125 | 0.88% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. | SERVICES LLC 550 S. HOPE ST., SUITE 1000 LOS ANGELES, CA 90071 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 9.12% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 31 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $254 | $254 | 1.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $115 | — | $115 | 0.88% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INSURANCE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 13.42% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. SUITE 300 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $143 | — | $143 | 1.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $235 | — | $235 | 5.49% |
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 | 152 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 217 | $2.1M |
| Dental | AETNA LIFE INSURANCE CO. | 378 | $189K |
| Vision | VISION SERVICE PLAN | 148 | $28K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $29K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $14K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 58 | $1.1M |
| Other(4 contracts, 4 carriers) | AFLAC | 150 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 378 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.