| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN M WORD3 Filed as: JOHN WORD III | — | CALIFORNIA CHOICE | $46K | — | $46K | 9.50% |
| JOHN M WORD3 | 721 S PARKER ST STE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | $609 | — | $609 | 1.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT | ADMINISTRATORS INC 721 S PARKER ST STE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | $609 | — | $609 | 1.87% |
| DANIEL TYLER ADAMSON3 | 2700 N MAIN ST #945 SANTA ANA, CA 92705 | CONTINENTAL AMERICAN INSURANCE COMPANY | $37 | — | $37 | 1.45% |
| MITCHELL A KAUCHER3 | 3064 GIBRALTAR AVENUE COSTA MESA, CA 92626 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.55% |
| JOHN M WORD3 | 781 S PARKER #300 ORANGE, CA 92868 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.51% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.47% |
| DANIEL TYLER ADAMSON3 | 405 S. HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.27% |
| SANDRA R ROKOP3 Filed as: SANDRA ROKOP | 74 CONGRESS PL IRVINE, CA 92602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.27% |
| TERRANCE M LUCZAJ3 | 1201 MAIN ST STE 2300 COLUMBIA, SC 29201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.16% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 1501 ORANGETHORPE SUITE 108 FULLERTON, CA 90620 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.12% |
| 9999MARK J WOOD3 | 10370 HEMET ST 210 RIVERSIDE, CA 92505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.08% |
| CAROL S POOLE3 | 2502 BLOSSOM TRAIL MANSFIELD, TX 76063 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| TOMMY C FLEESON3 | 2034 10 ST NORTH JACKSONVILLE BCH, FL 32250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| DONALD F WASINGER3 | 74 CONGRESS PLACE IRVINE, CA 92602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| JEFFREY T JOHNSON3 | 15590 SYRACUSE LANE FONTANA, CA 92336 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| JOY E GUNDERSON3 | 990 SOUTH HEDIN CIRCLE ANAHEIM, CA 92807 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ INSURANCE SVCS INC | 255 E. RINCON ST #110 CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.04% |
| JOY E GUNDERSON3 | 4531 VALLECITO LN YORBA LINDA, CA 92886 | AFLAC | $173 | — | $173 | 8.24% |
| JOHN M WORD3 Filed as: JOHN MARION WORD III | 721 S PARKER ST STE 300 ORANGE, CA 92868 | AFLAC | $117 | — | $117 | 5.57% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $47 | — | $47 | 2.24% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $39 | — | $39 | 1.86% |
| LAURA CANO3 | 718 PARK LN CORONA, CA 92879 | AFLAC | $18 | — | $18 | 0.86% |
| JEFFERY WAYNE GUNDERSON3 | 4531 VALLECITO LN YORBA LINDA, CA 92886 | AFLAC | $17 | — | $17 | 0.81% |
| WILLA MAY ROBINSON3 | 12458 AUTUMN BREEZE ST CERRITOS, CA 90703 | AFLAC | $13 | — | $13 | 0.62% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $11 | — | $11 | 0.52% |
| CECILIA CALLEROS GOMEZ3 | 328 N CLINTON ST ORANGE, CA 92867 | AFLAC | $4 | — | $4 | 0.19% |
| SANDRA R ROKOP3 | 36471 ROYAL SAGE CT PALM DESERT, CA 92211 | AFLAC | $3 | — | $3 | 0.14% |
| VALERIE S. LEWIS3 Filed as: VALERIE S LEWIS | 6127 S RAINBOW BLVD STE 110 LAS VEGAS, NV 89118 | AFLAC | $2 | — | $2 | 0.10% |
| LAURIE ANN UNDERNEHR3 | 3007 N 18TH ST ROGERS, AR 72756 | AFLAC | $2 | — | $2 | 0.10% |
| LISA TAYLOR3 Filed as: LISA RENE TAYLOR | 3311 W LINCOLN AVE APT 5 ANAHEIM, CA 92801 | AFLAC | $1 | — | $1 | 0.05% |
| MONIQUE GLADYS MATLOCK3 | 7431 COLBY CIR WESTMINSTER, CA 92683 | AFLAC | $1 | — | $1 | 0.05% |
| PATRICIA ANN BOSCH3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $1 | — | $1 | 0.05% |
| COLLEEN M LAPRADE3 | 6005 HIDDEN VALLEY RD STE 150 CARLSBAD, CA 92011 | AFLAC | $1 | — | $1 | 0.05% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | 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 | 465 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 477 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 475 | $488K |
| Dental(2 contracts, 2 carriers) | CALIFORNIA CHOICE | 546 | $521K |
| Vision | CALIFORNIA CHOICE | 475 | $488K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 546 | $59K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 575 | $5K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 518 | $28K |
| Other(5 contracts, 5 carriers) | CALIFORNIA CHOICE | 575 | $526K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.