| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SANDRA L KAWANO3 | 1654 SOLANO AVE SUITE D ALBANY, CA 94707 | BLUE SHIELD OF CALIFORNIA | $4K | $126K | $130K | 4.22% |
| ACRISURE LLC3 | 31 PELL ST NEW YORK, NY 10013 | KAISER FOUNDATION HEALTH PLAN, INC. | $48K | — | $48K | 4.07% |
| ACRISURE LLC3 Filed as: ACISURE LLC | — | DELTA DENTAL OF CA | $12K | — | $12K | 4.00% |
| DONALD C SAVOY INC3 Filed as: DONALD C SAVOY | — | DELTA DENTAL OF CA | $6K | — | $6K | 2.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP | 750 THE CITY DR. S SUITE 450 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 4.35% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD L LEE & SONS | 31 PELL ST NEW YORK, NY 10013 | HARTFORD LIFE & ACCIDENT | $6K | — | $6K | 10.00% |
| LINDA M NAPOLI3 | 5335 YARMOUTH AVE APT 106 ENCINO, CA 91316 | AFLAC | $1K | $92 | $1K | 4.04% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS CT BURBANK, CA 91501 | AFLAC | $613 | $21 | $634 | 2.05% |
| PAUL GALLEGOS3 | 10519 SHOSHONE AVE GRANADA HILLS, CA 91344 | AFLAC | $420 | — | $420 | 1.36% |
| HAROLD L LEE & SON INC3 | 400 ESTUDILLO AVE SAN LEANDRO, CA 94577 | AFLAC | $371 | — | $371 | 1.20% |
| SHEM J BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $242 | — | $242 | 0.78% |
| SALLY CHUNG3 | 236 WEST PORTAL AVE #498 SAN FRANCISCO, CA 94127 | AFLAC | $163 | — | $163 | 0.53% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $132 | — | $132 | 0.43% |
| LEANN C LEVINE3 | 1049 16TH STREET 9 SANTA MONICA, CA 90403 | AFLAC | $124 | — | $124 | 0.40% |
| HING AND ASSOCIATES INSURANCE3 Filed as: HING AND ASSOCIATES INS BROKERS INC | 301 E COLORADO BLVD STE 200 PASADENA, CA 91101 | AFLAC | $92 | — | $92 | 0.30% |
| CHERYL HING3 | PO BOX 80967 SAN MARINO, CA 91118 | AFLAC | $84 | — | $84 | 0.27% |
| CHARLES EDWARD WILLIAMS3 | 1411 N GRAND OAKS AVE PASADENA, CA 91104 | AFLAC | $81 | — | $81 | 0.26% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $73 | — | $73 | 0.24% |
| BALTOR INSURANCE SERVICES3 | 11 AIRPORT BLVD STE 105 SOUTH SAN FRANCISCO, CA 94080 | AFLAC | $72 | — | $72 | 0.23% |
| SPALDING GROUP ENTERPRISES3 | 29404 QUAIL RUN DR AGOURA HILLS, CA 91301 | AFLAC | $66 | — | $66 | 0.21% |
| KELLIE D COOK3 | 2470 STEARNS ST #294 SIMI VALLEY, CA 93063 | AFLAC | $62 | — | $62 | 0.20% |
| LILY YAN3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $49 | — | $49 | 0.16% |
| MICHALE GOODMAN3 | 5419 S LA CIENEGA BLVD LOS ANGELES, CA 90056 | AFLAC | $40 | — | $40 | 0.13% |
| RHOEL T VALDEZ3 Filed as: RHOEL VALDEZ | 20016 BLYTHE ST WINNETKA, CA 91306 | AFLAC | $27 | — | $27 | 0.09% |
| DE VITA B MCKENZIE3 | 1139 IROLO ST LOS ANGELES, CA 90006 | AFLAC | $21 | — | $21 | 0.07% |
| JULIE ATKINS3 | 16321 PACIFIC COAST HWY SPC 6 PACIFIC PALISADES, CA 90272 | AFLAC | $21 | — | $21 | 0.07% |
| LENHI TANG3 | PO BOX 4142 EL MONTE, CA 91734 | AFLAC | $20 | — | $20 | 0.06% |
| KRISTINA J KUNZ3 | 118 GRANVILLE WAY SAN FRANCISCO, CA 94127 | AFLAC | $19 | — | $19 | 0.06% |
| ANNA JANICE RUIZ3 | 2596 17TH AVE SAN FRANCISCO, CA 94116 | AFLAC | $15 | — | $15 | 0.05% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $10 | — | $10 | 0.03% |
| RICHARD J KUNZ3 | 601 MONTGOMERY ST STE 1475 SAN FRANCISCO, CA 94111 | AFLAC | $10 | — | $10 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H WILLIS JR | 1431 NE 55TH STREET FT LAUDERDALE, FL 33334 | AFLAC | $9 | — | $9 | 0.03% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD SUITE 204 NASHVILLE, TN 37215 | AFLAC | $7 | — | $7 | 0.02% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $7 | — | $7 | 0.02% |
| DAVID REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | AFLAC | $6 | — | $6 | 0.02% |
| ADAM H MICHAELS3 | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $6 | — | $6 | 0.02% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $4 | — | $4 | 0.01% |
| CHRIS BRANSON3 | PO BOX 930 MAKAWAO, HI 96768 | AFLAC | $4 | — | $4 | 0.01% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE LOS ANGELES, CA 90045 | AFLAC | $3 | — | $3 | 0.01% |
| PAUL GLOBAL BENEFITS INC3 Filed as: PAUL SCHNAIDER | 2521 SHADOWBROOKE RD BRENTWOOD, CA 94513 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $2 | — | $2 | 0.01% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 3 CITYPLACE DR SUITE 900 SAINT LOUIS, MT 63141 | AFLAC | $2 | — | $2 | 0.01% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE ST TOLUCA LAKE, CA 91602 | AFLAC | $2 | — | $2 | 0.01% |
| CESAR A TORRES3 Filed as: CESAR TORRES | 26312 VALENZUELA CIR MISSION VIEJO, CA 92691 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAE R FISHER3 | 50 W LEMON AVE STE 2 MONROVIA, CA 91016 | AFLAC | $1 | — | $1 | 0.00% |
| OLENA K SHEA3 | 3 MITCHELL PL UNIT 18C NEW YORK, NY 10017 | AFLAC | $1 | — | $1 | 0.00% |
| IOANNIS T GRATSINOPOULOS3 | 1893 E DAULBY ST MERIDIAN, ID 83642 | AFLAC | $1 | — | $1 | 0.00% |
| OWEN JOHNSTON3 | 1231 W 2ND ST SANTA ANNA, CA 92703 | AFLAC | $1 | — | $1 | 0.00% |
| RACHEL SUNDAY3 | 6080 CENTER DR FL 6 LOS ANGELES, CA 90045 | AFLAC | $1 | — | $1 | 0.00% |
| ACRISURE LLC3 Filed as: ACISURE LLC | — | DELTA DENTAL | $824 | — | $824 | 4.00% |
| DONALD C SAVOY INC3 | — | DELTA DENTAL | $412 | — | $412 | 2.00% |
| CAROLINE D MORNINGSTAR3 Filed as: CAROLINE Y MOY | 2169 E 28TH STREET BROOKLYN, NY 11229 | AFLAC | $302 | — | $302 | 3.34% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 1443 E WASHINGTON BLVD 128 PASADENA, CA 91104 | AFLAC | $187 | — | $187 | 2.07% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $159 | — | $159 | 1.76% |
| TREVOR FENNELL3 | 7 HIGHLAND LN EAST HAMPTON, NY 11937 | AFLAC | $74 | — | $74 | 0.82% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA G LEES | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $60 | — | $60 | 0.66% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD LEE & SONS INC | 31 PELL STREET NEW YORK, NY 10013 | AFLAC | $56 | — | $56 | 0.62% |
| CHRISTY DAY ASSOCIATES LLC3 | 199 WATER ST FL 23 NEW YORK, NY 10038 | AFLAC | $54 | — | $54 | 0.60% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $37 | — | $37 | 0.41% |
| TOMMY TAM3 | 501 W 52ND ST APT 3G NEW YORK, NY 10019 | AFLAC | $21 | — | $21 | 0.23% |
| SHEM J BOSTICK3 | 1325 MOUNT HERMON RD SUITE 13B SALISBURY, MD 21804 | AFLAC | $16 | — | $16 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: KEVIN G GALLAGHER | 2640 LAKE SHORE DR UNIT 411 RIVIERA BEACH, FL 33404 | AFLAC | $11 | — | $11 | 0.12% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $9 | — | $9 | 0.10% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $7 | — | $7 | 0.08% |
| DEVITA MCKENZIE3 | 1139 IROLO ST LOS ANGELES, CA 90006 | AFLAC | $2 | — | $2 | 0.02% |
| MICHAEL BURACK3 | 46 THREEPENCE DR MELVILLE, NY 11747 | AFLAC | $2 | — | $2 | 0.02% |
| STEPHEN WHITE3 Filed as: STEPHEN P WHITE | 5 EMERALD LN MONTEBELLO, NY 10901 | AFLAC | $2 | — | $2 | 0.02% |
| SEAN FX GLEASON LLC3 | 52 HOLIDAY PARK DR HAUPPAUGE, NY 11788 | AFLAC | $2 | — | $2 | 0.02% |
| TODD J BURKE CORP3 Filed as: TODD J BURKE | 199 WATER ST FL 23 NEW YORK, NY 10038 | AFLAC | $1 | — | $1 | 0.01% |
| KENNETH B MCPHERSON3 | 1932 E DEERE AVE SUITE 240 SANTA ANA, CA 92705 | AFLAC | $1 | — | $1 | 0.01% |
| DALE I DAVIS3 | 5892 CEDARCREEK LN LEXINGTON, KY 40515 | AFLAC | — | — | $0 | 0.00% |
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 | 363 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 222 | $3.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CA | 262 | $315K |
| Vision | BLUE SHIELD OF CALIFORNIA | 222 | $3.1M |
| Life insurance | BLUE SHIELD OF CALIFORNIA | 222 | $3.1M |
| Long-term disability | HARTFORD LIFE & ACCIDENT | 340 | $64K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 222 | $3.1M |
| Other(2 contracts) | AFLAC | 34 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.