| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZAIN INSURANCE SERVICES3 | — | KAISER PERMANENTE | $300K | — | $300K | 9.36% |
| ZAIN INSURANCE SERVICES3 | — | ANTHEM BLUE CROSS | $210K | — | $210K | 9.36% |
| ZAIN INSURANCE SERVICES3 | — | HEALTH NET | $44K | — | $44K | 9.36% |
| ZAIN INSURANCE SERVICES3 | 721 S PARKER ST STE 140 ORANGE, CA 928684715 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 2.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT ADMIN INC | 721 S PARKER ST STE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | — | $9K | $9K | 1.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT ADMIN INC | 721 S PARKER ST STE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 0.47% |
| ZAIN INSURANCE SERVICES3 | — | CIGNA + OSCAR | $28K | — | $28K | 9.36% |
| ZAIN INSURANCE SERVICES3 | — | UNITEDHEALTHCARE OF CALIFORNIA | $25K | — | $25K | 9.36% |
| JOY E GUNDERSON3 Filed as: JOY ELIZABETH GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 3.23% |
| ZAIN INSURANCE SERVICES3 | 721 S. PARKER ST. SUITE 140 ORANGE, CA 92868 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.01% |
| DANIEL TYLER ADAMSON3 | 405 S. HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $706 | — | $706 | 0.66% |
| JONATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN CYPRESS, CA 90630 | CONTINENTAL AMERICAN INSURANCE COMPANY | $591 | — | $591 | 0.55% |
| LAURA CANO3 Filed as: LAURA ELENA CANO | 718 PARK LN CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $411 | — | $411 | 0.38% |
| WILLA MAY ROBINSON3 Filed as: WILLA MAJORS ROBINSON | 12458 AUTUMN BREEZE CERRITOS, CA 90703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $309 | — | $309 | 0.29% |
| JEFFERY WAYNE GUNDERSON3 | 4531 VALLECITO LN YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE COMPANY | $296 | — | $296 | 0.28% |
| DANIEL TYLER ADAMSON3 | 2700 N MAIN ST #945 SANTA ANA, CA 92705 | CONTINENTAL AMERICAN INSURANCE COMPANY | $221 | — | $221 | 0.21% |
| MITCHELL A KAUCHER3 Filed as: MITCHELL ALAN KAUCHER | 3064 GIBRALTAR AVENUE COSTA MESA, CA 92626 | CONTINENTAL AMERICAN INSURANCE COMPANY | $102 | — | $102 | 0.10% |
| JANICE M ADAMSON3 Filed as: JANICE MELISSA ADAMSON | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $97 | — | $97 | 0.09% |
| SANDRA R ROKOP3 Filed as: SANDRA ROSANNE ROKOP | 36471 ROYAL SAGE COURT PALM DESERT, CA 92211 | CONTINENTAL AMERICAN INSURANCE COMPANY | $57 | — | $57 | 0.05% |
| DONALD F WASINGER3 Filed as: DONALD FRANCIS WASINGER | 36471 ROYAL SAGE COURT PALM DESERT, CA 92211 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.01% |
| MARK J WOOD3 Filed as: MARK JASON WOOD | 10370 HEMET ST 210 RIVERSIDE, CA 92505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| JODY BAKER3 | 13308 VERONA TUSTIN, CA 92782 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| CHRIS KELLY3 | 1260 N DUTTON STE 180 SANTA ROSA, CA 95401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| TOMMY C FLEESON3 Filed as: TOMMY CLIFTON FLEESON | 3395 MICHELSON DR APT 5155 IRVINE, CA 926123434 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| CAROL SUZANNE POOLE3 | 3700S DEERWOOD TRAIL MANISTIQUE, MI 40854 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JEFFREY T JOHNSON3 Filed as: JEFFREY THOMAS JOHNSON | 30766 MAINMAST DR AGOURA HILLS, CA 913011960 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| CHERYL M HATHCOCK3 Filed as: CHERYL MARIE HATHCOCK | PO BOX 330186 FORT WORTH, TX 76163 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| CECILIA MONIQUE CALLEROS-GOMEZ3 | 821 E LA HABRA BLVD LA HABRA, CA 906315531 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DAWN T SUCHECKI3 Filed as: DAWN TYLER SUCHECKI | 316 CHURCH ST WILMINGTON, NC 26401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| COLLEEN M LAPRADE3 Filed as: COLLEEN MARIE LAPRADE | 1600 WILLIAMS STREET COLUMBIS, CA 29201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ZAIN INSURANCE SERVICES3 | — | SMILESAVER | $10K | — | $10K | 17.00% |
| ZAIN INSURANCE SERVICES3 | — | VSP | $6K | — | $6K | 12.03% |
| ZAIN INSURANCE SERVICES3 | — | SHARP HEALTH PLAN | $4K | — | $4K | 9.36% |
| ZAIN INSURANCE SERVICES3 | — | LANDMARK HEALTHPLAN | $4K | — | $4K | 11.65% |
| JOY E GUNDERSON3 | 2824 SAINT ANDREWS RD FAIRFIELD, CA 94534 | AFLAC | $834 | — | $834 | 2.96% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $767 | $63 | $830 | 2.95% |
| ZAIN INSURANCE SERVICES3 | 721 S PARKER ST STE 300 ORANGE, CA 92868 | AFLAC | $552 | — | $552 | 1.96% |
| JONATHAN ALI HAJIMOMEN3 | 5752 WHISTLER CIR HUNTINGTON BEACH, CA 92649 | AFLAC | $263 | $19 | $282 | 1.00% |
| ZAIN INSURANCE SERVICES3 | 721 S PARKER ST STE 140 ORANGE, CA 92868 | AFLAC | $139 | — | $139 | 0.49% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $111 | — | $111 | 0.39% |
| JEFFERY WAYNE GUNDERSON3 | 2824 SAINT ANDREWS RD FAIRFIELD, CA 94534 | AFLAC | $62 | — | $62 | 0.22% |
| CECILIA CALLEROS GOMEZ3 | 328 N CLINTON ST ORANGE, CA 92867 | AFLAC | $50 | — | $50 | 0.18% |
| JANINE BOOTH3 | 1588 N CLINTON ST ORANGE, CA 92867 | AFLAC | $18 | $25 | $43 | 0.15% |
| SANDRA R ROKOP3 | 36471 ROYAL SAGE CT PALM DESERT, CA 92211 | AFLAC | $39 | — | $39 | 0.14% |
| WILLA MAY ROBINSON3 | 12458 AUTUMN BREEZE ST CERRITOS, CA 90703 | AFLAC | $36 | — | $36 | 0.13% |
| VALERIE S. LEWIS3 Filed as: VALERIE S LEWIS | 6127 S RAINBOW BLVD STE 110 LAS VEGAS, NV 89118 | AFLAC | $24 | — | $24 | 0.09% |
| LAURIE ANN UNDERNEHR3 | 911 SW LOST RIVER SHORES DR STUART, FL 34997 | AFLAC | $22 | — | $22 | 0.08% |
| LAURA CANO3 | 718 PARK LN CORONA, CA 92879 | AFLAC | $16 | — | $16 | 0.06% |
| COLLEEN M LAPRADE3 | 1053 HERMES AVE ENCINITAS, CA 92024 | AFLAC | $8 | — | $8 | 0.03% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $7 | — | $7 | 0.02% |
| MONIQUE GLADYS MATLOCK3 | 7431 COLBY CIR WESTMINSTER, CA 92683 | AFLAC | $5 | — | $5 | 0.02% |
| LISA TAYLOR3 Filed as: LISA RENE TAYLOR | 3311 W LINCOLN AVE APT 5 ANAHEIM, CA 92801 | AFLAC | $3 | — | $3 | 0.01% |
| MICHAEL F IVES3 | 6127 S RAINBOW BLVD STE 110B LAS VEGAS, NV 89118 | AFLAC | $3 | — | $3 | 0.01% |
| VICTORIA KAMMER3 | 5417 AEGEAN WAY LAS VEGAS, NV 89149 | AFLAC | $1 | — | $1 | 0.00% |
| TAMMY A MORGART3 Filed as: TAMMY A SWAIN | 10736 KNICKERBOCKER AVE LAS VEGAS, NV 89166 | AFLAC | $1 | — | $1 | 0.00% |
| ZAIN INSURANCE SERVICES3 | — | EYEMED | $2K | — | $2K | 12.00% |
| ZAIN INSURANCE SERVICES3 | — | WESTERN HEALTH ADVANTAGE | $1K | — | $1K | 9.36% |
| ZAIN INSURANCE SERVICES3 | — | AMERITAS | -$229 | — | -$229 | — |
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 | 512 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 7 carriers) | KAISER PERMANENTE | 522 | $6.5M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 589 | $529K |
| Vision(2 contracts, 2 carriers) | VSP | 352 | $68K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 589 | $650K |
| Short-term disability | AFLAC | 41 | $28K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 562 | $213K |
| Other(4 contracts, 4 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 916 | $612K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 916 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.