| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRYSON INSURANCE AGENCY INC.3 | 3777 LONG BEACH BLVD. LONG BEACH, CA 90807 | AETNA HEALTH INC. | $25K | $0 | $25K | 4.43% |
| BRYSON INSURANCE AGENCY INC.3 | 3777 LONG BEACH BLVD. LONG BEACH, CA 90807 | AETNA LIFE INSURANCE CO. | $8K | $0 | $8K | 5.48% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY INC. | 25B HANOVER ROAD FLORHAM PARK, NJ 07932 | AETNA LIFE INSURANCE CO. | $2K | $0 | $2K | 1.23% |
| BRYSON INSURANCE AGENCY INC.3 | 3777 LONG BEACH BLVD. SUITE 500 LONG BEACH, CA 90807 | GUARDIAN | $3K | $0 | $3K | 13.33% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $451 | $0 | $451 | 3.48% |
| BRYSON INSURANCE AGENCY INC.3 Filed as: BRYSON INSURANCE AGENCY INC | 3777 LONG BEACH BLVD SUITE 500 LONG BEACH, CA 90807 | AFLAC | $201 | $0 | $201 | 1.55% |
| JONATHAN ALI HAJIMOMEN3 | 5752 WHISTLER CIR HUNTINGTON BEACH, CA 92649 | AFLAC | $185 | $0 | $185 | 1.43% |
| LUZ CASTILLO BARRIGA3 Filed as: LUZ C BARRIGA | 22019 JUAN AVE HAWAIIAN GARDENS, CA 90716 | AFLAC | $115 | $0 | $115 | 0.89% |
| VERONICA RINCON3 | 2018 S WOODLAND PL SANTA ANA, CA 92707 | AFLAC | $106 | $0 | $106 | 0.82% |
| AURELIO VELA3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $78 | $0 | $78 | 0.60% |
| HECTOR ALFONSO FRIAS3 | 26791 ALISO CREEK RD PMB 1052 ALISO VIEJO, CA 92656 | AFLAC | $65 | $0 | $65 | 0.50% |
| DAVID G GINN3 | 2314 S VINEYARD AVE SUITE G ONTARIO, CA 91761 | AFLAC | $52 | $0 | $52 | 0.40% |
| CARLOS VAZQUEZ3 | 9633 TAMARIND AVE FONTANA, CA 92335 | AFLAC | $48 | $0 | $48 | 0.37% |
| CECILIA CALLEROS GOMEZ3 | 328 N. CLINTON ST. ORANGE, CA 92867 | AFLAC | $31 | $0 | $31 | 0.24% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $26 | $0 | $26 | 0.20% |
| TASHA W DOSSETT3 | 581A HEARDTOWN RD TUPELO, MS 38804 | AFLAC | $26 | $0 | $26 | 0.20% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY STE 400 ALISO VIEJO, CA 92656 | AFLAC | $22 | $0 | $22 | 0.17% |
| CORTNEY M ROJAS3 | 1649 HUNTINGTON DR SOUTH PASADENA, CA 91030 | AFLAC | $22 | $0 | $22 | 0.17% |
| TOMMY C FLEESON3 | 3395 MICHELSON DR APT 5155 IRVINE, CA 92612 | AFLAC | $7 | $0 | $7 | 0.05% |
| ANDREW R GRETHEL3 | 11739 HICKORY RUN CT LOVELAND, OH 45140 | AFLAC | $5 | $0 | $5 | 0.04% |
| NANCY J ATCHUE3 | 1785 NEWBERRY DR BULLHEAD CITY, AZ 86442 | AFLAC | $3 | $0 | $3 | 0.02% |
| SCOTT W BLACKSHEAR3 | 108 ALSACE CT PONTE VEDRA BEACH, FL 32082 | AFLAC | $3 | $0 | $3 | 0.02% |
| JAMES J GRETHEL3 | 865 CEDAR DR LOVELAND, OH 45140 | AFLAC | $2 | $0 | $2 | 0.02% |
| TERRANCE M LUCZAJ3 | 27 DIETES CT LADERA RANCH, CA 96294 | AFLAC | $2 | $0 | $2 | 0.02% |
| JOY E GUNDERSON3 | 2824 SAINT ANDREWS RD. FAIRFIELD, CA 94534 | AFLAC | $1 | $0 | $1 | 0.01% |
| AMANDA M GRIFFITH3 | 11400 SE 8TH ST STE 375 BELLEVUE, WA 98004 | AFLAC | $1 | $0 | $1 | 0.01% |
| KERSTIN J VANZANTEN3 | 40152 STOWE RD TEMECULA, CA 92591 | AFLAC | $1 | $0 | $1 | 0.01% |
| MARK J WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $1 | $0 | $1 | 0.01% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH INC. | 264 | $701K |
| Dental | AETNA LIFE INSURANCE CO. | 264 | $140K |
| Vision | AETNA LIFE INSURANCE CO. | 264 | $140K |
| Life insurance | GUARDIAN | 163 | $22K |
| Short-term disability | AFLAC | 32 | $13K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN | 163 | $35K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 163 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.