| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZAIN INSURANCE SERVICES3 | — | CALIFORNIA CHOICE | $585K | — | $585K | 9.48% |
| ZAIN INSURANCE SERVICES3 | 721 S PARKER ST STE 140 ORANGE, CA 928684715 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 2.13% |
| 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 | — | $9K | $9K | 1.99% |
| 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 | — | $4K | $4K | 0.95% |
| JOY E GUNDERSON3 | 4531 VALLECITO LN YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 4.19% |
| ZAIN INSURANCE SERVICES3 Filed as: ZAIN INSURANCE SERVI | 721 S PARKER #300 ORANGE, CA 92868 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 3.26% |
| DANIEL TYLER ADAMSON3 | 405 S. HIBISCUS WAY ANAHEIM, CA 92808 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.61% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 1501 ORANGETHORPE SUITE 108 FULLERTON, CA 92831 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.81% |
| LAURA CANO3 Filed as: LAURA E CANO | 718 PARK LANE CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $500 | — | $500 | 0.36% |
| DANIEL TYLER ADAMSON3 | 2700 N MAIN ST #945 SANTA ANA, CA 92705 | CONTINENTAL AMERICAN INSURANCE COMPANY | $385 | — | $385 | 0.28% |
| JEFFERY WAYNE GUNDERSON3 Filed as: JEFFERY GUNDERSON | 4531 VALLECITO LN YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE COMPANY | $303 | — | $303 | 0.22% |
| WILLA MAY ROBINSON3 Filed as: WILLA M ROBINSON | 12458 AUTUMN BREEZE CERRITOS, CA 90703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $231 | — | $231 | 0.17% |
| MITCHELL A KAUCHER3 | 3064 GIBRALTAR AVENUE COSTA MESA, CA 92626 | CONTINENTAL AMERICAN INSURANCE COMPANY | $158 | — | $158 | 0.11% |
| JANICE M ADAMSON3 | 495 E. RINCON ST #212 CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $129 | — | $129 | 0.09% |
| SANDRA R ROKOP3 Filed as: SANDRA ROKOP | 74 CONGRESS PL IRVINE, CA 92602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $79 | — | $79 | 0.06% |
| CHRIS KELLY3 | 1260 N DUTTON STE 180 SANTA ROSA, CA 95401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $43 | — | $43 | 0.03% |
| CECILIA M CALLEROS GOMEZ3 | 17671 COWAN STREET SUITE 125 IRVINE, CA 92614 | CONTINENTAL AMERICAN INSURANCE COMPANY | $35 | — | $35 | 0.03% |
| MARK J WOOD3 | 10370 HEMET ST 210 RIVERSIDE, CA 92505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.02% |
| DONALD F WASINGER3 | 74 CONGRESS PLACE IRVINE, CA 92602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | — | $21 | 0.02% |
| TOMMY C FLEESON3 | 2034 10 ST NORTH JACKSONVILLE BCH, FL 32250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| JEFFREY T JOHNSON3 | 15590 SYRACUSE LANE FONTANA, CA 92336 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| CAROL S POOLE3 | 2502 BLOSSOM TRAIL MANSFIELD, TX 76063 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| JODY BAKER3 | 13308 VERONA TUSTIN, CA 92782 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| JOY E GUNDERSON3 | 990 SOUTH HEDIN CIRCLE ANAHEIM, CA 92807 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| RANCE SVCS INC3 | TERRANCE LUCZAJ INSU 255 E. RINCON ST #110 CORONA, CA 92879 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| CHERYL M HATHCOCK3 Filed as: CHERYL M MATHCOCK | PO BOX 330186 FORT WORTH, TX 76163 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $1K | — | $1K | 3.92% |
| JOY E GUNDERSON3 | 2824 SAINT ANDREWS RD FAIRFIELD, CA 94534 | AFLAC | $1K | $87 | $1K | 3.77% |
| ZAIN INSURANCE SERVICES3 | 721 S PARKER ST STE 300 ORANGE, CA 92868 | AFLAC | $744 | — | $744 | 2.25% |
| JONATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DR CYPRESS, CA 90630 | AFLAC | $402 | $28 | $430 | 1.30% |
| ZAIN INSURANCE SERVICES3 | 721 S PARKER ST STE 140 ORANGE, CA 92868 | AFLAC | $400 | — | $400 | 1.21% |
| JEFFERY WAYNE GUNDERSON3 | 2824 SAINT ANDREWS RD FAIRFIELD, CA 94534 | AFLAC | $120 | $33 | $153 | 0.46% |
| JANICE M ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $128 | — | $128 | 0.39% |
| JANINE BOOTH3 | 1588 N CLINTON ST ORANGE, CA 92867 | AFLAC | $124 | — | $124 | 0.37% |
| WILLA MAY ROBINSON3 | 12458 AUTUMN BREEZE ST CERRITOS, CA 90703 | AFLAC | $52 | $10 | $62 | 0.19% |
| CECILIA CALLEROS GOMEZ3 | 328 N CLINTON ST ORANGE, CA 92867 | AFLAC | $55 | — | $55 | 0.17% |
| SANDRA R ROKOP3 | 36471 ROYAL SAGE CT PALM DESERT, CA 92211 | AFLAC | $46 | — | $46 | 0.14% |
| VALERIE S. LEWIS3 Filed as: VALERIE S LEWIS | 6127 S RAINBOW BLVD STE 110 LAS VEGAS, NV 89118 | AFLAC | $24 | — | $24 | 0.07% |
| LAURIE ANN UNDERNEHR3 | 911 SW LOST RIVER SHORES DR STUART, FL 34997 | AFLAC | $22 | — | $22 | 0.07% |
| LAURA CANO3 | 718 PARK LN CORONA, CA 92879 | AFLAC | $18 | — | $18 | 0.05% |
| COLLEEN M LAPRADE3 | 1053 HERMES AVE ENCINITAS, CA 92024 | AFLAC | $9 | — | $9 | 0.03% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $8 | — | $8 | 0.02% |
| MONIQUE GLADYS MATLOCK3 | 7431 COLBY CIR WESTMINSTER, CA 92683 | AFLAC | $7 | — | $7 | 0.02% |
| LISA TAYLOR3 Filed as: LISA RENE TAYLOR | 3311 W LINCOLN AVE APT 5 ANAHEIM, CA 92801 | AFLAC | $6 | — | $6 | 0.02% |
| 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% |
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 | 490 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 490 | $6.2M |
| Dental(2 contracts, 2 carriers) | CALIFORNIA CHOICE | 594 | $6.6M |
| Vision | CALIFORNIA CHOICE | 490 | $6.2M |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 594 | $640K |
| Short-term disability | AFLAC | 39 | $33K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 543 | $230K |
| Other(4 contracts, 4 carriers) | CALIFORNIA CHOICE | 594 | $6.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 594 | — |
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.