| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC | 540 W MADISON STREET, SUITE 1200 CHICAGO, IL 60661 | BLUE CROSS OF CALIFORNIA | $57K | $0 | $57K | 3.08% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | BLUE CROSS OF CALIFORNIA | $43K | $0 | $43K | 2.34% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 4.51% |
| BETTY MURDOCK3 | 7216 TESSERA PKWY LAGO VISTA, TX 78645 | AFLAC | $815 | $0 | $815 | 3.40% |
| LISA M HELZING3 Filed as: LISA HELZING | 620 JILL CT DES PLAINES, IL 60018 | AFLAC | $146 | $0 | $146 | 0.61% |
| RHOLAN WONG3 | 2825 TILDEN AVE LOS ANGELES, CA 90064 | AFLAC | $141 | $0 | $141 | 0.59% |
| JUANITA BURKS & ASSOCIATES3 | PO BOX 10341 MARINA DEL REY, CA 90295 | AFLAC | $140 | $0 | $140 | 0.58% |
| YAMASAKI & COMPANY3 Filed as: YAMASAKI AND COMPANY INC | 1840 W 186TH ST STE 200 TORRANCE, CA 90504 | AFLAC | $125 | $0 | $125 | 0.52% |
| KAREN M HUGHES3 Filed as: KAREN HUGHES | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $120 | $0 | $120 | 0.50% |
| TONI Y DECAMP3 Filed as: TONI DECAMP | 4227 S MERIDIAN C425 PUYALLUP, WA 98373 | AFLAC | $103 | $0 | $103 | 0.43% |
| VANESSA IRENE HERRERA3 Filed as: VANESSA HERRERA | 200 E AVENIDA DE LA MERCED MONTEBELLO, CA 90640 | AFLAC | $90 | $0 | $90 | 0.38% |
| KARI S. TAMKE3 Filed as: KARI TAMKE | 45 54TH PL APT 4 LONG BEACH, CA 90803 | AFLAC | $81 | $0 | $81 | 0.34% |
| CLAY W CAMPBELL3 Filed as: CLAY CAMPBELL | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $76 | $0 | $76 | 0.32% |
| DAWN A CHRISTENSEN3 Filed as: DAWN CHRISTENSEN | 24516 APPLE ST NEWHALL, CA 91321 | AFLAC | $65 | $0 | $65 | 0.27% |
| KATHLEEN S HANSON3 Filed as: KATHLEEN HANSON | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $63 | $0 | $63 | 0.26% |
| TERESA PHILLIPS3 | 3099 W CHAPMAN AVE APT 126 ORANGE, CA 92868 | AFLAC | $58 | $0 | $58 | 0.24% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH BUZZELLO | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $57 | $0 | $57 | 0.24% |
| PETER P MORSE3 Filed as: PETER MORSE | 1026 W 21ST ST SAN PEDRO, CA 90731 | AFLAC | $54 | $0 | $54 | 0.23% |
| ELIZABETH D PEARSON3 Filed as: ELIZABETH PEARSON | 4609 103RD LN NE KIRKLAND, WA 98033 | AFLAC | $44 | $0 | $44 | 0.18% |
| JANELLE M ZAMORA3 Filed as: JANELLE ZAMORA | 421 W BROADWAY APT 4157 LONG BEACH, CA 90802 | AFLAC | $39 | $0 | $39 | 0.16% |
| JESSICA PEREZ3 | 6167 BRISTOL PKWY STE 106 CULVER CITY, CA 90230 | AFLAC | $36 | $0 | $36 | 0.15% |
| MEENA JOLLY3 | 28 MADDYBETH CRESCENT BRAMPTON, WY 00000 | AFLAC | $32 | $0 | $32 | 0.13% |
| RENE CASTRO3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $31 | $0 | $31 | 0.13% |
| ALDO LASTRA3 | 9733 NW 45TH LN DORAL, FL 33178 | AFLAC | $31 | $0 | $31 | 0.13% |
| YOLANDA F LASTRA3 Filed as: YOLANDA LASTRA | 9733 NW 45TH LN DORAL, FL 33178 | AFLAC | $28 | $0 | $28 | 0.12% |
| PACIFIC BENEFIT SOLUTIONS LLC3 | PO BOX 5734 KENT, WA 98064 | AFLAC | $28 | $0 | $28 | 0.12% |
| STEVEN T SPEICHINGER3 Filed as: STEVEN SPEICHINGER | 3008 CHRISTIAN AVE WAUSAU, WI 54401 | AFLAC | $27 | $0 | $27 | 0.11% |
| BRAD FISHER3 | 819 W PRAIRIE ST. SULLIVAN, IL 61951 | AFLAC | $27 | $0 | $27 | 0.11% |
| JEANNINE CAPPUSO3 | 44355 DELACROIX LN CLINTON TWP, MI 48038 | AFLAC | $24 | $0 | $24 | 0.10% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 5335 YARMOUTH AVE APT 106 ENCINO, CA 91316 | AFLAC | $23 | $0 | $23 | 0.10% |
| ANDREA M MACIAS3 Filed as: ANDREA MACIAS | 7216 TESSERA PKWY LAGO VISTA, TX 78645 | AFLAC | $20 | $0 | $20 | 0.08% |
| VICTORIA T CAMPBELL3 Filed as: VICTORIA CAMPBELL | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $16 | $0 | $16 | 0.07% |
| MARY POHLMAN3 | 27735 214TH AVE SE MAPLE VALLEY, WA 98038 | AFLAC | $15 | $0 | $15 | 0.06% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS CT BURBANK, CA 91501 | AFLAC | $14 | $0 | $14 | 0.06% |
| MARCO A ERAZO3 Filed as: MARCO ERAZO | 4160 SW 152ND AVE MIRAMAR, FL 33027 | AFLAC | $13 | $0 | $13 | 0.05% |
| KRISTOPHER KEAHIOLALO3 | 531 HAHAIONE ST APT 11 A HONOLULU, HI 96825 | AFLAC | $12 | $0 | $12 | 0.05% |
| TODD V MASON3 Filed as: TODD MASON | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $11 | $0 | $11 | 0.05% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE LOS ANGELES, CA 90045 | AFLAC | $11 | $0 | $11 | 0.05% |
| DAVID J MCCLELLAN3 Filed as: DAVID HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $10 | $0 | $10 | 0.04% |
| THERESA REDDING3 | 71 COUNTRY CLUB DR BLOOMINGDALE, IL 60108 | AFLAC | $8 | $0 | $8 | 0.03% |
| BRANDON PENKO3 Filed as: BRANDON HOOBLER | 1230 S 336TH ST STE A FEDERAL WAY, WA 98003 | AFLAC | $8 | $0 | $8 | 0.03% |
| JOANNA G MATHERLY3 Filed as: JOANNA MATHERLY | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $7 | $0 | $7 | 0.03% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $6 | $0 | $6 | 0.03% |
| LIVIER MARIA RAMIREZ3 Filed as: LIVIER RAMIREZ | 1107 FAIR OAKS AVE UNIT 882 SOUTH PASADENA, CA 91030 | AFLAC | $5 | $0 | $5 | 0.02% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $5 | $0 | $5 | 0.02% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 5266 N KUFALK LN BYRON, IL 61010 | AFLAC | $5 | $0 | $5 | 0.02% |
| CRAIG WAYNE SOTTILE3 Filed as: CRAIG HANSEN | 6848 RIVERDALE DR SE TUMWATER, WA 98501 | AFLAC | $4 | $0 | $4 | 0.02% |
| MICHAEL C WALKER3 Filed as: MICHAEL STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $4 | $0 | $4 | 0.02% |
| JOSEPH J DERTHICK3 Filed as: JOSEPH DERTHICK | 15428 FLATBUSH AVE NORWALK, CA 90650 | AFLAC | $4 | $0 | $4 | 0.02% |
| ELIZABETH M GASPAROVIC3 Filed as: ELIZABETH GASPAROVIC | 18 N SMITH ST PALATINE, IL 60067 | AFLAC | $3 | $0 | $3 | 0.01% |
| DENNIS M COPLAND3 Filed as: DENNIS COPLAND | 6817 K AVE STE 104 PLANO, TX 75074 | AFLAC | $3 | $0 | $3 | 0.01% |
| GREGORY SHARP3 | 702 E 5TH ST COAL VALLEY, IL 61240 | AFLAC | $3 | $0 | $3 | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JAMES BROWN | 2522 OWENS LANDING TRL NW KENNESAW, GA 30152 | AFLAC | $3 | $0 | $3 | 0.01% |
| HEATHER TOMSON3 | 63607 NE 9TH STREET RENTON, WA 98056 | AFLAC | $3 | $0 | $3 | 0.01% |
| MICHAEL R. FISHER3 Filed as: MICHAEL FISHER | 50 W LEMON AVE STE 2 MONROVIA, CA 91016 | AFLAC | $3 | $0 | $3 | 0.01% |
| NANCY E ODOM3 Filed as: NANCY ODOM | 5921 STONE MEADOW DR PLANO, TX 75093 | AFLAC | $2 | $0 | $2 | 0.01% |
| SCALETTA INSURANCE AGENCY INC3 | 15 N WINDSOR DR ARLINGTON HEIGHTS, IL 60004 | AFLAC | $2 | $0 | $2 | 0.01% |
| JAVIER ORTIZ3 | 9620 NE 2ND AVE STE 203 MIAMI SHORES, FL 33138 | AFLAC | $1 | $0 | $1 | 0.00% |
| ANNE MARIE HUBBARD3 | 446 MORNING CANYON RD CORONA DEL MAR, CA 92625 | AFLAC | $1 | $0 | $1 | 0.00% |
| DENNIS J CASSENS3 Filed as: DENNIS CASSENS | 4646 E MARRILL RD BYRON, IL 61010 | AFLAC | $1 | $0 | $1 | 0.00% |
| TIMOTHY ASBY3 | 11500 GOLDEN WILLOW CT ZIONSVILLE, IN 46077 | AFLAC | $1 | $0 | $1 | 0.00% |
| DAVID REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | AFLAC | $1 | $0 | $1 | 0.00% |
| JEREMY M SKEETERS3 Filed as: JEREMY SKEETERS | 9695 W MONTE LINDO PEORIA, AZ 85383 | AFLAC | $1 | $0 | $1 | 0.00% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH LENZO | 701 ALBEROSKY WAY BATAVIA, IL 60510 | AFLAC | $1 | $0 | $1 | 0.00% |
| IQBAL SINGH BAGGA3 Filed as: IQBAL BAGGA | 10510 66TH AVE APT 5C FOREST HILLS, NY 11375 | AFLAC | $203 | $0 | $203 | 6.29% |
| RICHARD PETERSON3 | 19 IDLE DAY DR. CENTERPORT, NY 11721 | AFLAC | $56 | $0 | $56 | 1.73% |
| MARTIN F. CONROY3 Filed as: MARTIN CONROY | PO BOX 475 HOBOKEN, NJ 07030 | AFLAC | $54 | $0 | $54 | 1.67% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $23 | $0 | $23 | 0.71% |
| MERYL SURGAN3 | 326 JAEGER AVE MAYWOOD, NJ 07607 | AFLAC | $13 | $0 | $13 | 0.40% |
| JACQUES P DAVID CORPORATION3 | 5 MONFORT DR HUNTINGTON, NY 11743 | AFLAC | $10 | $0 | $10 | 0.31% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $6 | $0 | $6 | 0.19% |
| RUSSELL T BARRETT3 Filed as: RUSSELL BARRETT | 27 JULIANS WAY SARATOGA SPRINGS, NY 12866 | AFLAC | $6 | $0 | $6 | 0.19% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $4 | $0 | $4 | 0.12% |
| DOMINICK R SIRACUSA3 Filed as: DOMINICK SIRACUSA | 225 DOLSON AVE STE 304 MIDDLETOWN, NY 10940 | AFLAC | $4 | $0 | $4 | 0.12% |
| TODD BURKE3 | 199 WATER ST FL 23 NEW YORK, NY 10038 | AFLAC | $1 | $0 | $1 | 0.03% |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 229 | $2.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 293 | $145K |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 270 | $127K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 270 | $99K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 270 | $99K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 270 | $99K |
| Other(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 270 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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."
No prospect flags tripped on this filing.