| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS AGENCY INC | PO BOX 1189 SAN LUIS OBISPO, CA 93406 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $66K | $0 | $66K | 4.18% |
| ACRISURE LLC3 Filed as: DIBUDUO & DEFENDIS INS. BROKERS LLC | PO BOX 5479 FRESNO, CA 93755 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $9 | $0 | $9 | 0.00% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS AGENCY INC | PO BOX 1189 SAN LUIS OBISPO, CA 934061189 | KAISER FOUNDATION HEALTH PLAN INC | — | — | $0 | 0.00% |
| ASSUREDPARTNERS3 Filed as: MORRIS & GARRITANO INS AGENCY INC | 1122 LAUREL LANE SAN LUIS OBISPO, CA 93401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 4.27% |
| JOSE CRUZ BLANCO3 Filed as: JOSE C BLANCO | 2530 S RUBEL WAY APT K SANTA MARIA, CA 93455 | CONTINENTAL AMERICAN INSURANCE COMPANY | $921 | $0 | $921 | 2.75% |
| ACRISURE LLC3 Filed as: DIBUDUO & DEFENDIS INS BROKERS, LLC | 6873 N. WEST FRESNO, CA 93711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $557 | $0 | $557 | 1.66% |
| TIRZO A LOPEZ3 | 4368 HERADO DR GUADALUPE, CA 93434 | CONTINENTAL AMERICAN INSURANCE COMPANY | $404 | $0 | $404 | 1.21% |
| JENNIFER MARGARET ENGELMEIER3 Filed as: JENNIFER M ENGELMEIER | 1150 GROVE STREET SAN LUIS OBISPO, CA 93401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $284 | $0 | $284 | 0.85% |
| DAWN T SUCHECKI3 Filed as: DAWN M TYACK | 829 TEMPUS CIR ARROYO GRANDE, CA 93420 | CONTINENTAL AMERICAN INSURANCE COMPANY | $128 | $0 | $128 | 0.38% |
| DANIEL VORDALE INS SVCS INC3 | 712 MERCURY AVENUE LOMPOC, CA 93436 | CONTINENTAL AMERICAN INSURANCE COMPANY | $112 | $0 | $112 | 0.33% |
| BRENDA LOREN BERNSTEIN3 Filed as: BRENDA L BERNSTEIN | 1003 N 12TH ST GROVER BEACH, CA 93433 | CONTINENTAL AMERICAN INSURANCE COMPANY | $85 | $0 | $85 | 0.25% |
| BRIAN MCKELLAR3 | 1342 TRAPPERS RDG AMMON, ID 83401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $42 | $0 | $42 | 0.13% |
| ACRISURE LLC3 Filed as: DIBUDUO & DEFENDIS INS AGCY INC | PO BOX 5479 FRESNO, CA 93755 | AFLAC | $63 | $0 | $63 | 4.44% |
| DAWN T SUCHECKI3 Filed as: DAWN M TYACK | 582 CAMINO MERCADO ARROYO GRANDE, CA 93420 | AFLAC | $33 | $0 | $33 | 2.33% |
| DANIEL VORDALE INS SVCS INC3 | 712 MERCURY AVENUE LOMPOC, CA 93436 | AFLAC | $28 | $0 | $28 | 1.97% |
| BRENDA LOREN BERNSTEIN3 | 1003 N 12TH ST GROVER BEACH, CA 93433 | AFLAC | $13 | $0 | $13 | 0.92% |
| AARON ROJO3 | 42990 PARK PL, APT 1 PALM DESERT, CA 92260 | AFLAC | $7 | $0 | $7 | 0.49% |
| TIRZO A LOPEZ3 | 4368 HERADO DR GUADALUPE, CA 93434 | AFLAC | $4 | $0 | $4 | 0.28% |
| JENNIFER MARGARET ENGELMEIER3 | 1150 GROVE STREET SAN LUIS OBISPO, CA 93401 | AFLAC | $2 | $0 | $2 | 0.14% |
| EDWARD D SOMMER3 Filed as: EDWARD A ECHEVERRIA | 1112 LA SERENA WAY NIPOMO, CA 93444 | AFLAC | $2 | $0 | $2 | 0.14% |
| BRIAN MCKELLAR3 | 1342 TRAPPERS RDG AMMON, ID 83401 | AFLAC | $1 | $0 | $1 | 0.07% |
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 | 352 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 352 | $2.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 352 | $1.6M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 352 | $1.6M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 352 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 352 | — |
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.