| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FONTAINE MCLAREN INC3 Filed as: FONTAINE MCLAREN, INC | 27509 AGOURA RD SUITE 203 AGOURA HILLS, CA 91301 | CALIFORNIA PHYSICIANS' SERVICE | $40K | — | $40K | 5.00% |
| FONTAINE MCLAREN INC3 Filed as: FONTAINE MCLAREN, INC. | 27509 AGOURA RD STE 203 AGOURA HILLS, CA 913015149 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | — | $13K | 5.23% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | INC. 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 1.43% |
| FONTAINE MCLAREN INC3 | 27509 AGOURA HILLS RD STE 203 AGOURA HILLS, CA 91301 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $10K | — | $10K | 9.88% |
| REGINALD QUEEN3 | 50 W LEMON AVE MONROVIA, CA 91016 | AFLAC | $6K | $1K | $7K | 16.51% |
| SERGIO ALBERTO SOLIS3 | 396 S CALIFORNIA AVE UNIT 88 WEST COVINA, CA 91793 | AFLAC | $1K | $109 | $1K | 2.80% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R FISHER | 50 W LEMON AVE STE 2 MONROVIA, CA 91016 | AFLAC | $730 | $109 | $839 | 2.10% |
| MJR INSURANCE SERVICES LLC3 | 5444 SEPULVEDA BLVD APT 106 SHERMAN OAKS, CA 91411 | AFLAC | $274 | — | $274 | 0.69% |
| RENEE SUZANNE CORSO3 | 16000 VENTURA BLVD #1120 ENCINO, CA 91436 | AFLAC | $270 | — | $270 | 0.68% |
| JACQUELINE VEGA3 | 9406 SWINTON AVE NORTH HILLS, CA 91343 | AFLAC | $121 | — | $121 | 0.30% |
| COLIN R LEVENSON3 | 3636 CLARINGTON AVE APT 1 LOS ANGELES, CA 90034 | AFLAC | $116 | — | $116 | 0.29% |
| MICHELLE ANN DERAS3 | 724 N LA PALOMA AVE ONTARIO, CA 91764 | AFLAC | $49 | — | $49 | 0.12% |
| LILY YAN3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $39 | — | $39 | 0.10% |
| STEPHANIE ROBINSON3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $35 | — | $35 | 0.09% |
| NANETTE STARK3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $19 | — | $19 | 0.05% |
| DOLORES M. ROMERO3 Filed as: DOLORES M ROMERO | 2529 BRENTMOOR CT SUWANEE, GA 30024 | AFLAC | $18 | — | $18 | 0.05% |
| LIVIER MARIA RAMIREZ3 | 1201 TOLEDO ST LOS ANGELES, CA 90042 | AFLAC | $14 | — | $14 | 0.04% |
| CHRISTOPHER UNDERWOOD3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $10 | — | $10 | 0.03% |
| HECTOR MARTINEZ3 Filed as: HECTOR C MARTINEZ | 1458 WESTERLY TER LOS ANGELES, CA 90026 | AFLAC | $7 | — | $7 | 0.02% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $4 | — | $4 | 0.01% |
| DE VITA B MCKENZIE3 | 1139 IROLO ST LOS ANGELES, CA 90006 | AFLAC | $1 | — | $1 | 0.00% |
| FONTAINE MCLAREN INC3 | 27509 AGOURA RD STE 203 AGOURA HILLS, CA 91301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 16.25% |
| FONTAINE MCLAREN INC3 | 27509 AGOURA RD STE 203 AGOURA HILLS, CA 91301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 12.40% |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 103 | $1.1M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 151 | $105K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 151 | $105K |
| Life insurance(3 contracts, 2 carriers) | AFLAC | 139 | $64K |
| Short-term disability | AFLAC | 45 | $40K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 103 | $807K |
| Other(3 contracts, 2 carriers) | AFLAC | 139 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.