| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | BLUE CROSS OF CALIFORNIA | $40K | — | $40K | 3.23% |
| CENTRAL CITY INS AGCY INC3 | 1040 NEVADA STREET SUITE 304 REDLANDS, CA 92374 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 0.56% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVE #F137 RIVERSIDE, CA 92503 | UDC DENTAL OF CALIFORNIA, INC | $3K | — | $3K | 10.87% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | VISION SERVICE PLAN | $1K | — | $1K | 5.79% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 10.83% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $40K | — | $40K | 630.70% |
| CENTRAL CITY INS AGCY INC3 Filed as: CENTRAL CITY INSURANCE AGENCY INC | 1040 NEVADA STREET SUITE 304 REDLANDS, CA 92374 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $7K | — | $7K | 109.54% |
| MARK D GOLDEN3 Filed as: MARK GOLDEN | 10370 HEMET STREET SUITE 210 RIVERSIDE, CA 92503 | AFLAC | $160 | — | $160 | 4.07% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | AFLAC | $80 | — | $80 | 2.04% |
| JULIE L WOLD3 Filed as: JULIE WOLD | 495 EAST RINCON STREET SUITE 212 CORONA, CA 92879 | AFLAC | $53 | — | $53 | 1.35% |
| DANIEL R CHAMBERLAIN3 Filed as: DANIEL CHAMBERLAIN | 333 NOOR DRIVE NORCO, CA 92860 | AFLAC | $52 | — | $52 | 1.32% |
| JEFFREY T JOHNSON3 Filed as: JEFFREY JOHNSON | 15590 SYRACUSE LANE FONTANA, CA 92336 | AFLAC | $42 | — | $42 | 1.07% |
| JOSEPH H FERRELL3 Filed as: JOSEPH FERRELL | 709 WEST FERN AVENUE REDLANDS, CA 92373 | AFLAC | $39 | — | $39 | 0.99% |
| JANICE ADAMSON3 | 495 EAST RINCON STREET SUITE 212 CORONA, CA 92879 | AFLAC | $37 | — | $37 | 0.94% |
| DWAYNE MARTINEZ3 | 3095 EAST PATRICK LANE SUITE 1 LAS VEGAS, NV 89120 | AFLAC | $15 | — | $15 | 0.38% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ | 255 EAST RINCON STREET SUITE 110 CORONA, CA 92879 | AFLAC | $12 | — | $12 | 0.31% |
| TOMMY C FLEESON3 Filed as: TOMMY FLEESON | 1300 SHETTER AVENUE APARTMENT 1041 JACKSONVILLE BEACH, FL 32250 | AFLAC | $11 | — | $11 | 0.28% |
| ARTHUR LEYVAS3 | 13062 SWEETFERN STREET MORENO VALLEY, CA 92553 | AFLAC | $6 | — | $6 | 0.15% |
| MARK WOOD3 | 315 WEST HACIENDA DRIVE CORONA, CA 92882 | AFLAC | $2 | — | $2 | 0.05% |
| DAWN T SUCHECKI3 Filed as: DAWN SUCHECKI | 3850 VINE STREET SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $1 | — | $1 | 0.03% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $171 | — | $171 | 5.01% |
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 | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 106 | $1.2M |
| Dental(2 contracts, 2 carriers) | UDC DENTAL OF CALIFORNIA, INC | 125 | $42K |
| Vision | VISION SERVICE PLAN | 108 | $18K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 81 | $10K |
| Long-term disability | STANDARD INSURANCE COMPANY | 14 | $12K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 106 | $1.2M |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 81 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.