| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | GUARDIAN LIFE INSURANCE COMPANY | $10K | $11K | $21K | 11.92% |
| DONALD C SAVOY INC3 Filed as: DONALD C. SAVOY INC | 445 BROADHOLLOW ROAD SUITE 119 MELVILLE, NY 11747 | GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 4.53% |
| ENROLLEASE3 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 1.55% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 28202 CABOT RD SUITE 600 LAGUNA NIGEL, CA 92677 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $6K | $3K | $9K | 5.17% |
| DAVID RISPLER3 | 35 KERI WAY WOODBURY, NY 11797 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 1.12% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $742 | — | $742 | 4.33% |
| VERONICA RINCON3 | 2018 S WOODLAND PL SANTA ANA, CA 92707 | AFLAC | $678 | — | $678 | 3.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY STE 400 ALISO VIEJO, CA 92656 | AFLAC | $462 | — | $462 | 2.70% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $216 | — | $216 | 1.26% |
| DAVID G GINN3 | 2314 S VINEYARD AVE SUITE G INTARIO, CA 91761 | AFLAC | $126 | — | $126 | 0.74% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $105 | — | $105 | 0.61% |
| CORTNEY M ROJAS3 | 1649 HUNTINGTON DR SOUTH PASADENA, CA 91030 | AFLAC | $66 | — | $66 | 0.39% |
| TASHA W DOSSETT3 | 581A HEARDTOWN RD TUPELO, MS 38804 | AFLAC | $65 | — | $65 | 0.38% |
| NANCY J ATCHUE3 | 1785 NEWBERRY DR BULLHEAD CITY, AZ 86442 | AFLAC | $17 | — | $17 | 0.10% |
| SCOTT W BLACKSHEAR3 | 181 OLETA WAY ST AUGUSTINE, FL 32095 | AFLAC | $14 | — | $14 | 0.08% |
| ANDREW R GRETHEL3 | 11739 HICKORY RUN CT LOVELAND, OH 45140 | AFLAC | $13 | — | $13 | 0.08% |
| NYDIA PAREDES3 | 26841 POVEDA MISSION VIEJO, CA 92691 | AFLAC | $9 | — | $9 | 0.05% |
| TERRANCE M LUCZAJ3 | 29 CRESTVIEW DR RANCHO SANTA MARGARITA, CA 92688 | AFLAC | $5 | — | $5 | 0.03% |
| AMANDA M GRIFFITH3 | 11400 SE 8TH ST STE 375 BELLEVUE, WA 98004 | AFLAC | $4 | — | $4 | 0.02% |
| JAMES J GRETHEL3 | 865 CEDAR DR LOVELAND, OH 45140 | AFLAC | $4 | — | $4 | 0.02% |
| JOY E GUNDERSON3 | 2144 DENA DR CONCORD, CA 94519 | AFLAC | $4 | — | $4 | 0.02% |
| KERSTIN J VANZANTEN3 | 40152 STOWE RD TEMECULA, CA 92591 | AFLAC | $3 | — | $3 | 0.02% |
| COLLEEN M LAPRADE3 | 1053 HERMES AVE ENCINITAS, CA 92024 | AFLAC | $3 | — | $3 | 0.02% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $3 | — | $3 | 0.02% |
| MARK J WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $2 | — | $2 | 0.01% |
| TOMMY C FLEESON3 | 3395 MICHELSON DR APT 5155 IRVINE, CA 92612 | AFLAC | $2 | — | $2 | 0.01% |
| LUZ CASTILLO BARRIGA3 Filed as: LUZ C BARRIGA | 22019 JUAN AVE HAWAIIAN GARDENS, CA 90716 | AFLAC | $2 | — | $2 | 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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 27 | $172K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 164 | $178K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY | 164 | $178K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY | 164 | $178K |
| Short-term disability | AFLAC | 67 | $17K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY | 164 | $195K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY | 164 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.