| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARRS MADDOCKS & ASSOC. INS. SVCS.3 Filed as: MARRS MADDOCKS & ASSOCIATES | 1903 WRIGHT PLACE, SUITE 250 CARLSBAD, CA 92008 | BLUE CROSS OF CALIFORNIA | $21K | — | $21K | 2.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | BLUE CROSS OF CALIFORNIA | $10K | — | $10K | 1.07% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC. | 3010 LAVA RIDGE COURT, SUITE 110 ROSEVILLE, CA 95661 | BLUE CROSS OF CALIFORNIA | — | $2K | $2K | 0.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | — | $24K | 2.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 2.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | 3.55% |
| MARRS MADDOCKS & ASSOC. INS. SVCS.3 Filed as: MARRS MADDOCKS & ASSICIATES | 1903 WRIGHT PLACE, SUITE 280 CARLSBAD, CA 92008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | 3.46% |
| NETTIE PENA3 | 1227 CASSIA TRAIL PALM SPRINGS, CA 92262 | AFLAC | $10K | $336 | $10K | 13.45% |
| MARRS MADDOCKS & ASSOC. INS. SVCS.3 Filed as: MARRS MADDOCKS & ASSOCIATE INS. SVC | 1903 WRIGHT PLACE, SUITE 250 CARLSBAD, CA 92008 | AFLAC | $7K | — | $7K | 9.82% |
| GEEORGE HUDSON3 | 58335 ARCADIA TRAIL YUCCA VALLEY, CA 92284 | AFLAC | $6K | $227 | $6K | 7.61% |
| HEATHER A. GRAHAM3 | 30755 AVENIDA JUAREZ CATHEDRAL CITY, CA 92234 | AFLAC | $3K | $72 | $3K | 4.44% |
| DOUGLAS J SUCHECKI3 Filed as: DOUGLAS J. SUCHECKI | 3850 VINE STREET, SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $3K | $157 | $3K | 4.23% |
| PETRAGLIA INSURANCE SERVICES INC3 Filed as: PETRAGLIA INSURANCE SERVICES INC. | 5924 BALFOUR COURT, SUITE 100 CARLSBAD, CA 92008 | AFLAC | $2K | $274 | $2K | 2.82% |
| AARON ROJO3 | P.O. BOX 4018 PALM DESERT, CA 92261 | AFLAC | $1K | — | $1K | 1.57% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 5963 LA PLACE COURT, SUITE 107 CARLSBAD, CA 92008 | AFLAC | $449 | $150 | $599 | 0.79% |
| LEONARD KROMMENHOEK3 | 36700 PICKFAIR STREET, APT. 11 CATHEDRAL CITY, CA 92234 | AFLAC | $187 | — | $187 | 0.25% |
| AARON ROJO3 | 72600 FRED WARING DR., APT. 4105 PALM DESERT, CA 92260 | AFLAC | $132 | — | $132 | 0.17% |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 600 S. HIDDEN VALLEY RD., SUITE 150 CARLSBAD, CA 92011 | AFLAC | $92 | $7 | $99 | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 3333 CAMINO DEL RIO S., SUITE 215 SAN DIEGO, CA 92108 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 11.16% |
| MARRS MADDOCKS & ASSOC. INS. SVCS.3 Filed as: MARRS MADDOCKS & ASSOCIATES | 1903 WRIGHT PLACE, SUITE 280 CARLSBAD, CA 92008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $427 | — | $427 | 2.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $203 | — | $203 | 1.07% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS INC. | 3010 LAVA RIDGE COURT, SUITE 110 ROSEVILLE, CA 95661 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $43 | $43 | 0.23% |
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 | 362 | 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) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 141 | $1.7M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 180 | $1.0M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $36K |
| Life insurance(3 contracts, 3 carriers) | AFLAC | 362 | $130K |
| Short-term disability | AFLAC | 149 | $76K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 141 | $1.7M |
| Other(3 contracts, 3 carriers) | AFLAC | 362 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.