| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FONTAINE MCLAREN INC3 Filed as: FONTAINE MCLAREN, INC | 21241 VENTURA BLVD STE 153 WOODLAND HILLS, CA 91364 | CALIFORNIA PHYSICIANS' SERVICE | $28K | — | $28K | 5.00% |
| FONTAINE MCLAREN INC3 Filed as: FONTAINE MCLAREN, INC. | 27509 AGOURA RD STE 203 AGOURA HILLS, CA 913015149 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | — | $18K | 4.84% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | INC. 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 1.39% |
| FONTAINE MCLAREN INC3 | 27509 AGOURA HILLS RD STE 203 AGOURA HILLS, CA 91301 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $9K | — | $9K | 9.90% |
| ROBERT M BAGDASARIAN3 | 1081 WESTWOOD BLVD STE 211 LOS ANGELES, CA 90024 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 20.00% |
| REGINALD QUEEN3 Filed as: REGINALD UQUEEN | 50 W LEMON AVE MONROVIA, CA 91016 | AFLAC | $9K | $266 | $10K | 29.28% |
| SERGIO ALBERTO SOLIS3 | 396 S CALIFORNIA AVE UNIT 88 WEST COVINA, CA 91793 | AFLAC | $1K | — | $1K | 4.10% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R FISHER | 50 W LEMON AVE STE 2 MONROVIA, CA 91016 | AFLAC | $1K | — | $1K | 3.43% |
| RENEE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $319 | $6 | $325 | 1.00% |
| MJR INSURANCE SERVICES LLC3 | 5444 SEPULVEDA BLVD APT 106 SHERMAN OAKS, CA 91411 | AFLAC | $276 | — | $276 | 0.85% |
| JACQUELINE VEGA3 | 9406 SWINTON AVE NORTH HILLS, CA 91343 | AFLAC | $111 | — | $111 | 0.34% |
| MICHELLE ANN DERAS3 | 724 N LA PALOMA AVE ONTARIO, CA 91764 | AFLAC | $72 | — | $72 | 0.22% |
| LILY YAN3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $36 | — | $36 | 0.11% |
| STEPHANIE ROBINSON3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $32 | — | $32 | 0.10% |
| NANETTE STARK3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $17 | — | $17 | 0.05% |
| DOLORES M. ROMERO3 Filed as: DOLORES M ROMERO | 2529 BRENTMOOR CT SUWANEE, GA 30024 | AFLAC | $17 | — | $17 | 0.05% |
| KRISTIN MILLER3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $17 | — | $17 | 0.05% |
| LIVIER MARIA RAMIREZ3 | 1201 TOLEDO ST LOS ANGELES, CA 90042 | AFLAC | $13 | — | $13 | 0.04% |
| CHRISTOPHER UNDERWOOD3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $9 | — | $9 | 0.03% |
| HECTOR MARTINEZ3 Filed as: HECTOR C MARTINEZ | 1458 WESTERLY TER LOS ANGELES, CA 90026 | AFLAC | $6 | — | $6 | 0.02% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $4 | — | $4 | 0.01% |
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 | 350 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 351 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 68 | $931K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 141 | $92K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 141 | $92K |
| Life insurance | AFLAC | 52 | $33K |
| Short-term disability | AFLAC | 52 | $33K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $45K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 68 | $550K |
| Other | AFLAC | 52 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.