| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMPUSYS INSURANCE SERVICES INC.3 | 3857 BIRCH STREET NEWPORT BEACH, CA 92660 | AETNA HEALTH, INC. | $49K | $0 | $49K | 4.33% |
| COMPUSYS INSURANCE SERVICES INC.3 | 3857 BIRCH STREET NEWPORT BEACH, CA 926602616 | AETNA LIFE INSURANCE CO. | $45K | $0 | $45K | 4.67% |
| COMPUSYS INSURANCE SERVICES INC.3 Filed as: COMPUSYS INS SVCS INC. | 3857 BIRCH STREET SUITE 404 NEWPORT BEACH, CA 92660 | AFLAC | $1K | $0 | $1K | 1.83% |
| OWEN JOHNSTON3 Filed as: OWEN C JOHNSTON | 1231 W 2ND STREET SANTA ANA, CA 92703 | AFLAC | $772 | $26 | $798 | 1.43% |
| BEATRICE ADRIANA REYES3 | 656 N K STREET SAN BERNARDINO, CA 92411 | AFLAC | $462 | $73 | $535 | 0.96% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $462 | $0 | $462 | 0.83% |
| BRUNN & COMPANY INC.3 | 19225 NE 202ND STREET WOODINVILLE, WA 98077 | AFLAC | $392 | $0 | $392 | 0.70% |
| STEPHANIE A REYNOSO3 | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $296 | $18 | $314 | 0.56% |
| ASHLEY JADE RITTER3 | 36 WINCHESTER TRAIL GOSHEN, IN 46526 | AFLAC | $258 | $0 | $258 | 0.46% |
| SUZANNE M BRUNN3 | 19225 NE 202ND STREET WOODINVILLE, WA 98077 | AFLAC | $254 | $0 | $254 | 0.45% |
| ANNETTE L. BURNS3 Filed as: ANNETTE L BURNS | 28303 BRYCE DR CASTAIC, CA 91384 | AFLAC | $183 | $0 | $183 | 0.33% |
| MITCHELL A KAUCHER3 Filed as: MITCHELL KAUCHER | 3293 IOWA STREET COSTA MESA, CA 92626 | AFLAC | $149 | $0 | $149 | 0.27% |
| PAUL B KIRTON JR3 | 5520 WILSHIRE BLVD APT 727 LOS ANGELES, CA 90036 | AFLAC | $132 | $0 | $132 | 0.24% |
| ACEVES INSURANCE SERVICES INC.3 | 9959 BROOKSHIRE AVE DOWNEY, CA 90240 | AFLAC | $86 | $0 | $86 | 0.15% |
| PAMELA BAKALY3 Filed as: PAMELA S BAKALY | 1041 14TH STREET HERMOSA BEACH, CA 90254 | AFLAC | $85 | $0 | $85 | 0.15% |
| MIRIAM F HUNGERFORD3 | 33622 HOLTZ HILL RD DANA POINT, CA 92629 | AFLAC | $84 | $0 | $84 | 0.15% |
| SCOTT W BLACKSHEAR3 | 181 OLETA WAY ST AUGUSTINE, FL 32095 | AFLAC | $64 | $0 | $64 | 0.11% |
| CASSANDRA GREEN3 | 4341 MARION AVE CYPRESS, CA 90630 | AFLAC | $63 | $0 | $63 | 0.11% |
| NYDIA PAREDES3 | 26841 POVEDA MISSION VIEJO, CA 92691 | AFLAC | $60 | $0 | $60 | 0.11% |
| NANCY J ATCHUE3 | 1785 NEWBERRY DR BULLHEAD CITY, AZ 86442 | AFLAC | $49 | $0 | $49 | 0.09% |
| GEOFFREY MALAIS3 | PO BOX 280717 NORTHRIDGE, CA 91328 | AFLAC | $46 | $0 | $46 | 0.08% |
| CESAR A TORRES3 | 26312 VALENZUELA CIR MISSION VIEJO, CA 92691 | AFLAC | $45 | $0 | $45 | 0.08% |
| JERAD C CROOKS3 | 540 S MAIN STREET BOURBON, IN 46504 | AFLAC | $42 | $0 | $42 | 0.08% |
| MARK J WOOD3 | 315 W HACIENDA DR CORONA, CA 92882 | AFLAC | $40 | $0 | $40 | 0.07% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $38 | $0 | $38 | 0.07% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $34 | $0 | $34 | 0.06% |
| LINDA M NAPOLI3 | 5335 YARMOUTH AVE APT 106 ENCINO, CA 91316 | AFLAC | $29 | $0 | $29 | 0.05% |
| DAWN A CHRISTENSEN3 | 24516 APPLE STREET NEWHALL, CA 91321 | AFLAC | $29 | $0 | $29 | 0.05% |
| STANLEY M WISE3 | 26217 N FOREST RD RIO VERDE, AZ 85263 | AFLAC | $29 | $0 | $29 | 0.05% |
| ALEJANDRA SAMANIEGO3 | 17715 OVERLOOK LOOP APT 4209 SAN ANTONIO, TX 78259 | AFLAC | $27 | $0 | $27 | 0.05% |
| LYDIA L FLORES3 | 8932 SAN ANTONIO AVE SOUTH GATE, CA 90280 | AFLAC | $27 | $0 | $27 | 0.05% |
| MYSTI LEE KING3 | 5745 E CONANT ST LONG BEACH, CA 90808 | AFLAC | $26 | $0 | $26 | 0.05% |
| PATRICIA GAIL LEES3 | 6055 E WASHINGTON BLVD SUITE 210 COMMERCE, CA 90040 | AFLAC | $25 | $0 | $25 | 0.04% |
| SHELIA H. HARTMAN3 Filed as: SHELIA H HARTMAN | 22801 VENTURA BLVD SUITE 205 WOODLAND HILLS, CA 91364 | AFLAC | $25 | $0 | $25 | 0.04% |
| PRICE, RAFFEL & LOWMAN INS.3 | 110 S SUNSET CANYON DR BURBANK, CA 91501 | AFLAC | $24 | $0 | $24 | 0.04% |
| EUGENE PEREZ3 | 22 RIVERBEND DR PALM COAST, FL 32137 | AFLAC | $23 | $0 | $23 | 0.04% |
| KARI S. TAMKE3 Filed as: KARI S TAMKE | 45 54TH PLACE APT 4 LONG BEACH, CA 90803 | AFLAC | $23 | $0 | $23 | 0.04% |
| AMANDA M GRIFFITH3 | 11400 SE 8TH STREET #375 BELLEVUE, WA 98004 | AFLAC | $22 | $0 | $22 | 0.04% |
| CRISTHIAN MARTINEZ3 | 495 E RINCON STREET SUITE 210 CORONA, CA 92879 | AFLAC | $21 | $0 | $21 | 0.04% |
| DAVID JACOB HOLPER3 | 1828 W 244TH STREET TORRANCE, CA 90501 | AFLAC | $21 | $0 | $21 | 0.04% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $20 | $0 | $20 | 0.04% |
| KORNELIJA NUMIC3 | 17621 17TH ST TUSTIN, CA 92780 | AFLAC | $18 | $0 | $18 | 0.03% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON INC. | 2211 MICHELSON DR SUITE 1150 IRVINE, CA 92612 | AFLAC | $17 | $0 | $17 | 0.03% |
| TERRANCE M LUCZAJ3 | 29 CRESTVIEW DR RANCHO SANTA MARGARITA, CA 92688 | AFLAC | $17 | $0 | $17 | 0.03% |
| TASHA W DOSSETT3 | 581A HEARDTOWN RD TUPELO, MS 38804 | AFLAC | $16 | $0 | $16 | 0.03% |
| EVELYN ARAIZA3 | 1726 W 15TH STREET SANTA ANA, CA 92706 | AFLAC | $16 | $0 | $16 | 0.03% |
| ROBERT D SANCHEZ3 | 28772 SANDY AVE MURRIETA, CA 92563 | AFLAC | $15 | $0 | $15 | 0.03% |
| ELIZABETH MICAELA VEGA3 | 11671 STRATHERN STREET NORTH HOLLYWOOD, CA 91605 | AFLAC | $13 | $0 | $13 | 0.02% |
| ANDREW R GRETHEL3 | 11739 HICKORY RUN CT LOVELAND, OH 45140 | AFLAC | $10 | $0 | $10 | 0.02% |
| OWEN JOHNSTON3 | 1231 W 2ND ST SANTA ANA, CA 92703 | AFLAC | $10 | $0 | $10 | 0.02% |
| DALE I DAVIS3 | 5892 CEDARCREEK LN LEXINGTON, KY 40515 | AFLAC | $10 | $0 | $10 | 0.02% |
| TOMMY C FLEESON3 | 3395 MICHELSON DR APT 5155 IRVINE, CA 92612 | AFLAC | $8 | $0 | $8 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES | 6701 CENTER DR W SUITE 1500 LOS ANGELES, CA 90045 | AFLAC | $7 | $0 | $7 | 0.01% |
| ROBERT CHARLES EMETT3 | 80579 APPLE CT INDIO, CA 92201 | AFLAC | $6 | $0 | $6 | 0.01% |
| JARED ERDMANN3 | 8472 GAY STREET CYPRESS, CA 90630 | AFLAC | $5 | $0 | $5 | 0.01% |
| JAMES J GRETHEL3 | 865 CEDAR DR LOVELAND, OH 45140 | AFLAC | $4 | $0 | $4 | 0.01% |
| JOY E GUNDERSON3 | 4531 VALLECITO LN YORBA LINDA, CA 92886 | AFLAC | $3 | $0 | $3 | 0.01% |
| KERSTIN J VANZANTEN3 | 40152 STOWE ROAD TEMECULA, CA 92591 | AFLAC | $3 | $0 | $3 | 0.01% |
| MARK H MAZZA3 | 1070 S RIMWOOD DR ANAHEIM, CA 92807 | AFLAC | $2 | $0 | $2 | 0.00% |
| JEFFREY T JOHNSON3 | 30766 MAINMAST DR AGOURA HILLS, CA 91301 | AFLAC | $2 | $0 | $2 | 0.00% |
| LESTER RAY BLACKSHEAR3 | 9192 SE 168TH COOK PL THE VILLAGES, FL 32162 | AFLAC | $2 | $0 | $2 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H WILLIS JR | 1431 NE 55TH STREET FORT LAUDERDALE, FL 33334 | AFLAC | $2 | $0 | $2 | 0.00% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $2 | $0 | $2 | 0.00% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M MILLER | 728 MERCER PLACE HUNTERSVILLE, NC 28078 | AFLAC | $1 | $0 | $1 | 0.00% |
| KAREN M HUGHES3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $1 | $0 | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $1 | $0 | $1 | 0.00% |
| COMPUSYS INSURANCE SERVICES INC.3 Filed as: COMPUSYS INSURANCE SERVICES, INC. | 3857 BIRCH STREET SUITE 404 NEWPORT BEACH, CA 92660 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 7.93% |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 326 | $2.1M |
| Dental | AETNA LIFE INSURANCE CO. | 326 | $957K |
| Vision | AETNA LIFE INSURANCE CO. | 326 | $957K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 329 | $53K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 329 | $53K |
| Other(2 contracts, 2 carriers) | AFLAC | 329 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 329 | — |
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.