| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SANDRA L KAWANO3 | 400 ESTUDILLO AVE STE 212 SAN LEANDRO, CA 94577 | BLUE SHIELD OF CALIFORNIA | $3K | $97K | $100K | 3.10% |
| SANDRA L KAWANO3 | 400 ESTUDILLO AVE STE 212 SAN LEANDRO, CA 94577 | BLUE SHIELD OF CALIFORNIA | $1K | $35K | $36K | 1.12% |
| ACRISURE LLC3 | 400 ESTUDILLO AVE STE 212 SAN LEANDRO, CA 94577 | KAISER FOUNDATION HEALTH PLAN, INC. | $60K | $0 | $60K | 3.66% |
| ACRISURE LLC3 Filed as: ACISURE LLC | — | DELTA DENTAL OF CA | $13K | $0 | $13K | 4.00% |
| DONALD C SAVOY INC3 Filed as: DONALD C SAVOY | — | DELTA DENTAL OF CA | $7K | $0 | $7K | 2.00% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD L LEE & SONS | 31 PELL ST NEW YORK, NY 10013 | HARTFORD LIFE & ACCIDENT | $8K | $0 | $8K | 10.00% |
| 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 | $3K | $0 | $3K | 3.60% |
| LINDA M NAPOLI3 | 17631 VENTURA BLVD 321 ENCINO, CA 91316 | AFLAC | $1K | — | $1K | 4.15% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS CT BURBANK, CA 91501 | AFLAC | $677 | — | $677 | 2.11% |
| PAUL GALLEGOS3 | 10519 SHOSHONE AVE GRANADA HILLS, CA 91344 | AFLAC | $442 | — | $442 | 1.37% |
| ACRISURE LLC3 | 400 ESTUDILLO AVE SAN LEANDRO, CA 94577 | AFLAC | $262 | — | $262 | 0.81% |
| HAROLD L LEE & SON INC3 | 400 ESTUDILLO AVE SAN LEANDRO, CA 94577 | AFLAC | $244 | — | $244 | 0.76% |
| SHEM J BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $214 | — | $214 | 0.67% |
| SALLY CHUNG3 | 236 WEST PORTAL AVE #498 SAN FRANCISCO, CA 94127 | AFLAC | $160 | — | $160 | 0.50% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $139 | — | $139 | 0.43% |
| LEANN C LEVINE3 | 1049 16TH STREET APT 9 SANTA MONICA, CA 90403 | AFLAC | $112 | — | $112 | 0.35% |
| RHOEL T VALDEZ3 | 20016 BLYTHE ST WINNETKA, CA 91306 | AFLAC | $98 | $0 | $98 | 0.30% |
| VINCENT HING3 | 4536 RINETTI LN LA CANADA, CA 91001 | AFLAC | $88 | — | $88 | 0.27% |
| HING AND ASSOCIATES INSURANCE3 Filed as: HING AND ASSOCIATES INS BROKERS INC | 301 E COLORADO BLVD STE 200 PASADENA, CA 91101 | AFLAC | $88 | — | $88 | 0.27% |
| CHARLES EDWARD WILLIAMS3 | 1411 N GRAND OAKS AVE PASADENA, CA 91104 | AFLAC | $81 | — | $81 | 0.25% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $74 | — | $74 | 0.23% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BLVD STE 400 BURLINGAME, CA 94010 | AFLAC | $70 | — | $70 | 0.22% |
| KELLIE D COOK3 | 2470 STEARNS ST #294 SIMI VALLEY, CA 93063 | AFLAC | $62 | — | $62 | 0.19% |
| LILY YAN3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $49 | — | $49 | 0.15% |
| MICHALE GOODMAN3 | 5419 S LA CIENEGA BLVD LOS ANGELES, CA 90056 | AFLAC | $40 | — | $40 | 0.12% |
| SPALDING GROUP ENTERPRISES3 | 29404 QUAIL RUN DR AGOURA HILLS, CA 91301 | AFLAC | $38 | — | $38 | 0.12% |
| L MATTJHEW SPALDING3 | 847 N HOLLYWOOD WAY STE 204 BURBANK, CA 91505 | AFLAC | $21 | $0 | $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 | 108 MADRONE AVE SAN FRANCISCO, CA 94127 | AFLAC | $18 | — | $18 | 0.06% |
| DE VITA B MCKENZIE3 | 1139 IROLO ST LOS ANGELES, CA 90006 | AFLAC | $17 | $0 | $17 | 0.05% |
| ANNA JANICE RUIZ3 | 2596 17TH AVE SAN FRANCISCO, CA 94116 | AFLAC | $13 | — | $13 | 0.04% |
| 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% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $9 | — | $9 | 0.03% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $7 | — | $7 | 0.02% |
| ADAM H MICHAELS3 | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $6 | — | $6 | 0.02% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD SUITE 204 NASHVILLE, TN 37215 | AFLAC | $6 | — | $6 | 0.02% |
| DAVID REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | AFLAC | $5 | — | $5 | 0.02% |
| CHRIS BRANSON3 | PO BOX 930 MAKAWAO, HI 96768 | AFLAC | $4 | — | $4 | 0.01% |
| CHRISTOPHER HAGER3 | 44 COLONIAL DR RANCHO MIRAGE, CA 92270 | 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% |
| 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% |
| OWEN JOHNSTON3 | 1231 W 2ND ST SANTA ANNA, CA 92703 | AFLAC | $1 | — | $1 | 0.00% |
| IOANNIS T GRATSINOPOULOS3 | 1893 E DAULBY ST MERIDIAN, ID 83642 | AFLAC | $1 | — | $1 | 0.00% |
| ACRISURE LLC3 Filed as: ACISURE LLC | — | DELTA DENTAL | $897 | $0 | $897 | 4.00% |
| DONALD C SAVOY INC3 | — | DELTA DENTAL | $449 | $0 | $449 | 2.00% |
| CAROLINE D MORNINGSTAR3 Filed as: CAROLINE Y MOY | 2169 E 28TH STREET BROOKLYN, NY 11229 | AFLAC | $251 | $0 | $251 | 3.29% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $146 | $0 | $146 | 1.91% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 1443 E WASHINGTON BLVD 128 PASADENA, CA 91104 | AFLAC | $117 | $16 | $133 | 1.74% |
| TREVOR FENNELL3 | 7 HIGHLAND LN EAST HAMPTON, NY 11937 | AFLAC | $80 | $0 | $80 | 1.05% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA G LEES | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $40 | $4 | $44 | 0.58% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $37 | $0 | $37 | 0.49% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY M DAY | 199 WATER ST FL 23 NEW YORK, NY 10038 | AFLAC | $27 | $0 | $27 | 0.35% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY M DAY | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $21 | $0 | $21 | 0.28% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD LEE & SONS INC | 31 PELL STREET NEW YORK, NY 10013 | AFLAC | $19 | $0 | $19 | 0.25% |
| TOMMY TAM3 | 2955 GRAND CONCOURSE APT A1 BRONX, NY 10468 | AFLAC | $11 | $0 | $11 | 0.14% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $9 | $0 | $9 | 0.12% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $8 | $0 | $8 | 0.10% |
| SHEM J BOSTICK3 | 1325 MOUNT HERMON RD SUITE 13B SALISBURY, MD 21804 | AFLAC | $8 | $0 | $8 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: KEVIN G GALLAGHER | 2640 LAKE SHORE DR UNIT 411 RIVIERA BEACH, FL 33404 | AFLAC | $6 | — | $6 | 0.08% |
| MICHAEL BURACK3 | 46 THREEPENCE DR MELVILLE, NY 11747 | AFLAC | $2 | $0 | $2 | 0.03% |
| STEPHEN WHITE3 Filed as: STEPHEN P WHITE | 5 EMERALD LN MONTEBELLO, NY 10901 | AFLAC | $2 | $0 | $2 | 0.03% |
| SEAN FX GLEASON LLC3 | 52 HOLIDAY PARK DR HAUPPAUGE, NY 11788 | AFLAC | $2 | $0 | $2 | 0.03% |
| KENNETH B MCPHERSON3 | 1932 E DEERE AVE SUITE 240 SANTA ANA, CA 92705 | AFLAC | $1 | $0 | $1 | 0.01% |
| DEVITA MCKENZIE3 | 1139 IROLO ST LOS ANGELES, CA 90006 | AFLAC | $1 | $0 | $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 | 497 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 497 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 214 | $3.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CA | 273 | $352K |
| Vision | BLUE SHIELD OF CALIFORNIA | 214 | $3.2M |
| Life insurance | BLUE SHIELD OF CALIFORNIA | 214 | $3.2M |
| Long-term disability | HARTFORD LIFE & ACCIDENT | 363 | $83K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 214 | $3.2M |
| Other(2 contracts) | AFLAC | 35 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.