| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT AND INSURANCE SOLUTIONS | 9576 TOPANGA CANYON BLVD. CHATSWORTH, CA 91311 | CALIFORNIA PHYSICIANS' SERVICE | $97K | — | $97K | 7.00% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 | 19360 RINALDI ST., SUITE 505 NORTHRIDGE, CA 91326 | HUMANA INSURANCE COMPANY | $6K | $86 | $7K | 12.86% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 | 19360 RINALDI ST., SUITE 505 NORTHRIDGE, CA 91326 | HUMANA DENTAL INSURANCE COMPANY | $2K | $100 | $2K | 12.49% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 16.98% |
| ELLEN G VALDEZ3 Filed as: ELLEN G. VALDEZ | 4339 RADFORD AVE. APT. 4 STUDIO CITY, CA 91601 | AFLAC | $605 | $284 | $889 | 7.31% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT AND INSURANCE SOLUTIONS | 19360 RINALDI ST. SUITE 530 NORTHRIDGE, CA 91326 | AFLAC | $555 | — | $555 | 4.56% |
| RHOEL T VALDEZ3 Filed as: RHOEL T. VALDEZ | 4339 RADFORD AVE. APT. 4 STUDIO CITY, CA 91604 | AFLAC | $243 | $77 | $320 | 2.63% |
| DORA BOSTICK3 | 1620 S. DITMAR ST. OCEANSIDE, CA 92054 | AFLAC | $220 | $77 | $297 | 2.44% |
| BRIAN KEITH GATLIN3 | 5252 BISHOP ST. APT. 1 CYPRESS, CA 90630 | AFLAC | $166 | $121 | $287 | 2.36% |
| RHOEL T VALDEZ3 Filed as: RHOEL T. VALDEZ | 20016 BLYTHE ST. WINNETKA, CA 91306 | AFLAC | $264 | $4 | $268 | 2.20% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK | 1620 S. DITMAR ST. OCEANSIDE, CA 92054 | AFLAC | $59 | $4 | $63 | 0.52% |
| KATHLEEN ANDERSON3 | 5251 VINELAND AVE. APT. 403 NORTH HOLLYWOOD, CA 91601 | AFLAC | $53 | — | $53 | 0.44% |
| KENNIESHA SHACOYE NEWSOME3 | 4565 W. MARTIN LUTHER KING JR. BLVD APT. 370 LOS ANGELES, CA 90016 | AFLAC | $23 | — | $23 | 0.19% |
| GINA MICHELLE VENTURINI3 | 207 S. ARDMORE AVE. LOS ANGELES, CA 90004 | AFLAC | $19 | — | $19 | 0.16% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 13.68% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $963 | — | $963 | 13.79% |
| OHM BENEFIT & INSURANCE SOLUTIONS3 Filed as: OHM BENEFIT & INSURANCE | 19360 RINALDI ST. SUITE 505 NORTHRIDGE, CA 91326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $442 | — | $442 | 13.75% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 110 | $1.4M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 119 | $69K |
| Vision | HUMANA INSURANCE COMPANY | 119 | $51K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 123 | $24K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 52 | $19K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 79 | $14K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 110 | $1.4M |
| Other(2 contracts, 2 carriers) | AFLAC | 123 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.