| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SANDRA L KAWANO3 | 31 PELL STREET NEW YORK, NY 10013 | AETNA LIFE INSURANCE | $107K | — | $107K | 5.27% |
| DONALD C SAVOY INC3 Filed as: DONALD SAVORY | 25 B HANOVER RD FLORHAM PARK, NJ 07932 | AETNA LIFE INSURANCE | $4K | — | $4K | 0.18% |
| ACRISURE LLC3 | 400 ESTUDILLO AVE STE 212 SAN LEANDRO, CA 94577 | KAISER FOUNDATION HEALTH PLAN, INC. | $64K | — | $64K | 3.99% |
| ACRISURE LLC3 Filed as: ACISURE LLC | — | DELTA DENTAL OF CA | $14K | — | $14K | 4.00% |
| DONALD C SAVOY INC3 Filed as: DONALD C SAVOY | — | DELTA DENTAL OF CA | $7K | — | $7K | 2.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LEE RISK MANAGEMENT | 31 PELL ST NEW YORK, NY 10013 | HARTFORD LIFE & ACCIDENT | $12K | — | $12K | 7.55% |
| 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 | 3.87% |
| LINDA M NAPOLI3 | 17631 VENTURA BLVD 321 ENCINO, CA 91316 | AFLAC | $2K | — | $2K | 5.28% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS CT BURBANK, CA 91501 | AFLAC | $715 | — | $715 | 2.43% |
| ACRISURE LLC3 | 400 ESTUDILLO AVE SAN LEANDRO, CA 94577 | AFLAC | $712 | — | $712 | 2.42% |
| PAUL GALLEGOS3 | 10519 SHOSHONE AVE GRANADA HILLS, CA 91344 | AFLAC | $332 | — | $332 | 1.13% |
| SHEM J BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $208 | — | $208 | 0.71% |
| RHOEL T VALDEZ3 | 20016 BLYTHE ST WINNETKA, CA 91306 | AFLAC | $192 | — | $192 | 0.65% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $107 | — | $107 | 0.36% |
| LEANN C LEVINE3 | 1049 16TH STREET APT 9 SANTA MONICA, CA 90403 | AFLAC | $100 | — | $100 | 0.34% |
| SALLY CHUNG3 | 236 WEST PORTAL AVE #498 SAN FRANCISCO, CA 94127 | AFLAC | $83 | — | $83 | 0.28% |
| CHARLES EDWARD WILLIAMS3 | 1411 N GRAND OAKS AVE PASADENA, CA 91104 | AFLAC | $81 | — | $81 | 0.27% |
| HING AND ASSOCIATES INSURANCE3 Filed as: HING AND ASSOCIATES INS BROKERS INC | 301 E COLORADO BLVD STE 200 PASADENA, CA 91101 | AFLAC | $75 | — | $75 | 0.25% |
| VINCENT HING3 | 4536 RINETTI LN LA CANADA, CA 91001 | AFLAC | $64 | — | $64 | 0.22% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $51 | — | $51 | 0.17% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BLVD STE 400 BURLINGAME, CA 94010 | AFLAC | $44 | — | $44 | 0.15% |
| MICHALE GOODMAN3 | 5419 S LA CIENEGA BLVD LOS ANGELES, CA 90056 | AFLAC | $42 | — | $42 | 0.14% |
| KELLIE D COOK3 | 2470 STEARNS ST #294 SIMI VALLEY, CA 93063 | AFLAC | $41 | — | $41 | 0.14% |
| L MATTHEW SPALDING3 | 847 N HOLLYWOOD WAY STE 204 BURBANK, CA 91505 | AFLAC | $38 | — | $38 | 0.13% |
| LILY YAN3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $34 | — | $34 | 0.12% |
| ANNA JANICE RUIZ3 | 2596 17TH AVE SAN FRANCISCO, CA 94116 | AFLAC | $15 | — | $15 | 0.05% |
| RICHARD J KUNZ3 | 601 MONTGOMERY ST STE 1475 SAN FRANCISCO, CA 94111 | AFLAC | $10 | — | $10 | 0.03% |
| KRISTINA J KUNZ3 | 108 MADRONE AVE SAN FRANCISCO, CA 94127 | AFLAC | $9 | — | $9 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H WILLIS JR | 1431 NE 55TH STREET FT LAUDERDALE, FL 33334 | AFLAC | $6 | — | $6 | 0.02% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $6 | — | $6 | 0.02% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $6 | — | $6 | 0.02% |
| ADAM H MICHAELS3 | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $6 | — | $6 | 0.02% |
| JOANNA G MATHERLY3 | 4581 MAJESTIC MEDOWS DR ARRINGTON, TN 37014 | 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% |
| LENHI TANG3 | PO BOX 4142 EL MONTE, CA 91734 | AFLAC | $2 | — | $2 | 0.01% |
| OLENA K SHEA3 | 3 MITCHELL PL UNIT 18C NEW YORK, NY 10017 | AFLAC | $1 | — | $1 | 0.00% |
| CAROLINE D MORNINGSTAR3 Filed as: CAROLINE Y MOY | 2169 E 28TH STREET BROOKLYN, NY 11229 | AFLAC | $251 | — | $251 | 3.37% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $144 | — | $144 | 1.93% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 1443 E WASHINGTON BLVD 128 PASADENA, CA 91104 | AFLAC | $99 | — | $99 | 1.33% |
| TREVOR FENNELL3 | 7 HIGHLAND LN EAST HAMPTON, NY 11937 | AFLAC | $78 | — | $78 | 1.05% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA G LEES | 1124 CHURCHS COURT BURBANK, CA 91501 | AFLAC | $40 | — | $40 | 0.54% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY M DAY | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $39 | — | $39 | 0.52% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $34 | — | $34 | 0.46% |
| SHEM J BOSTICK3 | 1325 MOUNT HERMON RD SUITE 13B SALISBURY, MD 21804 | AFLAC | $11 | — | $11 | 0.15% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $9 | — | $9 | 0.12% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $7 | — | $7 | 0.09% |
| MICHAEL BURACK3 | 46 THREEPENCE DR MELVILLE, NY 11747 | AFLAC | $2 | — | $2 | 0.03% |
| STEPHEN WHITE3 Filed as: STEPHEN P WHITE | 5 EMERALD LN MONTEBELLO, NY 10901 | AFLAC | $2 | — | $2 | 0.03% |
| SEAN FX GLEASON LLC3 | 52 HOLIDAY PARK DR HAUPPAUGE, NY 11788 | AFLAC | $2 | — | $2 | 0.03% |
| ACRISURE LLC3 Filed as: ACISURE LLC | — | DELTA DENTAL | $722 | — | $722 | 66.73% |
| DONALD C SAVOY INC3 | — | DELTA DENTAL | $361 | — | $361 | 33.36% |
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 | 358 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CA | 280 | $347K |
| Long-term disability | HARTFORD LIFE & ACCIDENT | 361 | $155K |
| Other(2 contracts) | AFLAC | 30 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.