| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $27K | $206 | $27K | 3.15% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 1104 AMHERST ST WINCHESTER, VA 22601 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 1.46% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | BLUE CROSS OF CALIFORNIA | -$2 | — | -$2 | -0.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST. STE. 2400 SAN DIEGO, CA 92101 | SUN LIFE ASSSURANCE COMPANY OF CANADA | $3K | — | $3K | 6.48% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SVCS OF CALIFORNIA | 750 B ST. STE. 2400 SAN DIEGO, CA 92101 | SUN LIFE ASSSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.52% |
| MCGRIFF INSURANCE SERVICES INC3 | 4480 WILLOW RD PLEASANTON, CA 945888519 | VISION SERVICE PLAN | $572 | — | $572 | 2.87% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES OF CA. INC. | 19100 VON KARMAN AVE STE 920 IRVINE, CA 92312 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 16.13% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 750 B STREET STE 2400 SAN DIEGO, CA 92101 | STANDARD INSURANCE COMPANY | $570 | — | $570 | 4.86% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | PO BOX 896620 CHARLOTTE, NC 28289 | STANDARD INSURANCE COMPANY | $268 | — | $268 | 2.29% |
| CHARISE A KINNAMAN3 | 3410 LA SIERRA AVENUE SUITE F137 RIVERSIDE, CA 92503 | STANDARD INSURANCE COMPANY | -$731 | — | -$731 | -6.23% |
| MARK D GOLDEN3 Filed as: MARK GOLDEN | 10370 HEMET STREET SUITE 210 RIVERSIDE, CA 92503 | AFLAC | $103 | — | $103 | 4.94% |
| CHARISE A KINNAMAN3 Filed as: CHARISE KINNAMAN | 3410 LA SIERRA AVENUE #F137 RIVERSIDE, CA 92503 | AFLAC | $42 | — | $42 | 2.02% |
| JEFFREY T JOHNSON3 | 30766 MAINMAST DR AGOURA HILLS, CA 91301 | AFLAC | $31 | — | $31 | 1.49% |
| JOSEPH H FERRELL3 | 709 WEST FERN AVE REDLANDS, CA 92373 | AFLAC | $29 | — | $29 | 1.39% |
| DANIEL R CHAMBERLAIN3 | 333 NOOR DRIVE NORCO, CA 92860 | AFLAC | $22 | — | $22 | 1.06% |
| JULIE L WOLD3 Filed as: JULIE WOLD | 7720 E MOONRIDGE LN ANAHEIM, CA 92808 | AFLAC | $18 | — | $18 | 0.86% |
| JANICE ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $10 | — | $10 | 0.48% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ | 435 HARRODS LN CHARLESTON, CA 29412 | AFLAC | $5 | — | $5 | 0.24% |
| TOMMY C FLEESON3 Filed as: TOMMY FLEESON | 1300 SHETTER AVENUE APARTMENT 1041 JACKSONVILLE BEACH, FL 32250 | AFLAC | $3 | — | $3 | 0.14% |
| MARK WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $2 | — | $2 | 0.10% |
| DWAYNE MARTINEZ3 | 3095 E PATRICK LN STE 1 LAS VEGAS, NV 89120 | AFLAC | $1 | — | $1 | 0.05% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 128 | $869K |
| Dental | SUN LIFE ASSSURANCE COMPANY OF CANADA | 85 | $46K |
| Vision | VISION SERVICE PLAN | 106 | $20K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 128 | $871K |
| Long-term disability | STANDARD INSURANCE COMPANY | 14 | $12K |
| Other | BLUE CROSS OF CALIFORNIA | 128 | $869K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.