| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTRAL CITY INS AGCY INC3 | 1040 NEVADA STREET SUITE 304 REDLANDS, CA 92374 | BLUE CROSS OF CALIFORNIA | $30K | — | $30K | 2.83% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | BLUE CROSS OF CALIFORNIA | $23K | — | $23K | 2.22% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA. INC. | PO BOX 4147 TUSTIN, CA 92781 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 0.67% |
| CENTRAL CITY INS AGCY INC3 | 330 NORTH D ST #120 SAN BERNARDIN, CA 92401 | BLUE CROSS OF CALIFORNIA | $829 | — | $829 | 0.08% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | UDC DENTAL OF CALIFORNIA, INC | $2K | — | $2K | 8.41% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 750 B ST. STE. 2400 SAN DIEGO, CA 921012476 | UDC DENTAL OF CALIFORNIA, INC | $385 | — | $385 | 1.59% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE # F137 RIVERSIDE, CA 92503 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 8.03% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 750 B ST. STE. 2400 SAN DIEGO, CA 92101 | UNION SECURITY INSURANCE COMPANY | $454 | — | $454 | 1.97% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA | 750 B ST. STE. 2400 SAN DIEGO, CA 921012476 | VISION SERVICE PLAN | $112 | — | $112 | 0.55% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| MARK D GOLDEN3 Filed as: MARK GOLDEN | 10370 HEMET STREET SUITE 210 RIVERSIDE, CA 92503 | AFLAC | $134 | — | $134 | 4.61% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | AFLAC | $59 | — | $59 | 2.03% |
| JEFFREY T JOHNSON3 Filed as: JEFFREY JOHNSON | 27321 PROVIDENT RD AGOURA HILLS, CA 91301 | AFLAC | $39 | — | $39 | 1.34% |
| JOSEPH H FERRELL3 Filed as: JOSEPH FERRELL | 709 WEST FERN AVE REDLANDS, CA 92373 | AFLAC | $37 | — | $37 | 1.27% |
| JULIE L WOLD3 Filed as: JULIE WOLD | 7720 E MOONRIDGE LN ANAHEIM, CA 92808 | AFLAC | $30 | — | $30 | 1.03% |
| DANIEL R CHAMBERLAIN3 Filed as: DANIEL CHAMBERLAIN | 333 NOOR DRIVE NORCO, CA 92860 | AFLAC | $28 | — | $28 | 0.96% |
| JANICE ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $19 | — | $19 | 0.65% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ | 435 HARRODS LN CHARLESTON, CA 29412 | AFLAC | $8 | — | $8 | 0.28% |
| TOMMY C FLEESON3 Filed as: TOMMY FLEESON | 1300 SHETTER AVENUE APARTMENT 1041 JACKSONVILLE BEACH, FL 32250 | AFLAC | $7 | — | $7 | 0.24% |
| DWAYNE MARTINEZ3 | 3095 E PATRICK LN STE 1 LAS VEGAS, NV 89120 | AFLAC | $5 | — | $5 | 0.17% |
| ARTHUR LEYVAS3 | 13062 SWEETFERN STREET MORENO VALLEY, CA 92553 | AFLAC | $4 | — | $4 | 0.14% |
| MARK WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $2 | — | $2 | 0.07% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $135 | — | $135 | 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 | 163 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 160 | $1.0M |
| Dental(2 contracts, 2 carriers) | UDC DENTAL OF CALIFORNIA, INC | 109 | $47K |
| Vision | VISION SERVICE PLAN | 108 | $20K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 160 | $1.0M |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 16 | $18K |
| Other | BLUE CROSS OF CALIFORNIA | 160 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
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.