| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | BLUE CROSS OF CALIFORNIA | $108K | $0 | $108K | 5.60% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | BLUE CROSS OF CALIFORNIA | $0 | $2K | $2K | 0.11% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | KAISER FOUNDATION HEALTH PLAN INC | $7K | $0 | $7K | 4.95% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | DELTA DENTAL OF CALIFORNIA | $7K | $0 | $7K | 5.00% |
| BETTY MURDOCK3 | 7216 TESSERA PKWY LAGO VISTA, TX 78645 | AFLAC | $537 | $0 | $537 | 2.92% |
| LINDA M NAPOLI3 | 17631 VENTURA BLVD #321 ENCINO, CA 91316 | AFLAC | $125 | $0 | $125 | 0.68% |
| RHOLAN CHAN WONG3 | 2825 TILDEN AVE LOS ANGELES, CA 90064 | AFLAC | $111 | $0 | $111 | 0.60% |
| JUANITA BURKS & ASSOCIATES3 | PO BOX 10341 MARINA DEL REY, CA 90295 | AFLAC | $93 | $0 | $93 | 0.51% |
| KAREN M HUGHES3 Filed as: KAREN HUGHES | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $90 | $0 | $90 | 0.49% |
| YAMASAKI & COMPANY3 Filed as: YAMASAKI AND COMPANY INC | 1840 W 186TH ST STE 200 TORRANCE, CA 90504 | AFLAC | $85 | $0 | $85 | 0.46% |
| TONI Y DECAMP3 | 4227 S MERIDIAN C425 PUYALLUP, WA 98373 | AFLAC | $81 | $0 | $81 | 0.44% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS CT BURBANK, CA 91501 | AFLAC | $78 | $0 | $78 | 0.42% |
| VANESSA IRENE HERRERA3 | 200 E AVENIDA DE LA MERCED MONTEBELLO, CA 90640 | AFLAC | $77 | $0 | $77 | 0.42% |
| KARI S. TAMKE3 Filed as: KARI S TAMKE | 45 54TH PL APT 4 LONG BEACH, CA 90803 | AFLAC | $64 | $0 | $64 | 0.35% |
| DAWN A CHRISTENSEN3 | 24516 APPLE ST NEWHALL, CA 91321 | AFLAC | $51 | $0 | $51 | 0.28% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $47 | $0 | $47 | 0.26% |
| TERESA PHILLIPS3 | 1433 E 139TH ST COMPTON, CA 90222 | AFLAC | $46 | $0 | $46 | 0.25% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $45 | $0 | $45 | 0.24% |
| KATHLEEN S HANSON3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $41 | $0 | $41 | 0.22% |
| ELIZABETH D PEARSON3 | 4609 103RD LN NE KIRKLAND, WA 98033 | AFLAC | $34 | $0 | $34 | 0.18% |
| SHEM J BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $33 | $0 | $33 | 0.18% |
| JANELLE M ZAMORA3 | 421 W BROADWAY APT 4157 LONG BEACH, CA 90802 | AFLAC | $31 | $0 | $31 | 0.17% |
| ALDO LASTRA3 | 9733 NW 45TH LN DORAL, FL 33178 | AFLAC | $24 | $0 | $24 | 0.13% |
| YOLANDA F LASTRA3 | 9733 NW 45TH LN DORAL, FL 33178 | AFLAC | $22 | $0 | $22 | 0.12% |
| PACIFIC BENEFIT SOLUTIONS LLC3 | PO BOX 5734 KENT, WA 98064 | AFLAC | $22 | $0 | $22 | 0.12% |
| BRAD FISHER3 | 819 W PRAIRIE ST. SULLIVAN, IL 61951 | AFLAC | $21 | $0 | $21 | 0.11% |
| JESSICA PEREZ3 | 6167 BRISTOL PKWY STE 106 CULVER CITY, CA 90230 | AFLAC | $20 | $0 | $20 | 0.11% |
| JOSEPH J DERTHICK3 | 15428 FLATBUSH AVE NORWALK, CA 90650 | AFLAC | $20 | $0 | $20 | 0.11% |
| JEANNINE CAPPUSO3 Filed as: JEANNINE MARIE CAPPUSO | 44355 DELACROIX LN CLINTON TWP, MI 48038 | AFLAC | $19 | $0 | $19 | 0.10% |
| ANDREA M MACIAS3 | 7216 TESSERA PKWY LAGO VISTA, TX 78645 | AFLAC | $16 | $0 | $16 | 0.09% |
| RENE CASTRO3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $12 | $0 | $12 | 0.07% |
| MARY POHLMAN3 | 8400 24TH AVE SW SEATTLE, WA 98106 | AFLAC | $12 | $0 | $12 | 0.07% |
| MARCO A ERAZO3 | 4160 SW 152ND AVE MIRAMAR, FL 33027 | AFLAC | $10 | $0 | $10 | 0.05% |
| KRISTOPHER KEAHIOLALO3 | 531 HAHAIONE ST APT 11 A HONOLULU, HI 96825 | AFLAC | $9 | $0 | $9 | 0.05% |
| CHRISTOPHER HAGER3 | 44 COLONIAL DR RANCHO MIRAGE, CA 92270 | AFLAC | $8 | $0 | $8 | 0.04% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $8 | $0 | $8 | 0.04% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $7 | $0 | $7 | 0.04% |
| VICTORIA T CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $6 | $0 | $6 | 0.03% |
| BRANDON PENKO3 Filed as: BRANDON C HOOBLER | 1230 S 336TH ST STE A FEDERAL WAY, WA 98003 | AFLAC | $6 | $0 | $6 | 0.03% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $5 | $0 | $5 | 0.03% |
| DAVID J REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | AFLAC | $5 | $0 | $5 | 0.03% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $4 | $0 | $4 | 0.02% |
| CHAD L NELSON3 | 5266 N KUFALK LN BYRON, IL 61010 | AFLAC | $4 | $0 | $4 | 0.02% |
| LIVIER MARIA RAMIREZ3 | 1107 FAIR OAKS AVE UNIT 882 SOUTH PASADENA, CA 91030 | AFLAC | $3 | $0 | $3 | 0.02% |
| CRAIG A HANSEN3 | 6848 RIVERDALE DR SE TUMWATER, WA 98501 | AFLAC | $3 | $0 | $3 | 0.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JAMES GRAYDON BROWN | 2522 OWENS LANDING TRL NW KENNESAW, GA 30152 | AFLAC | $3 | $0 | $3 | 0.02% |
| HEATHER L TOMSON3 | 13615 156TH AVE SE RENTON, WA 98059 | AFLAC | $2 | $0 | $2 | 0.01% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R FISHER | 50 W LEMON AVE STE 2 MONROVIA, CA 91016 | AFLAC | $2 | $0 | $2 | 0.01% |
| JAVIER L ORTIZ3 | 9620 NE 2ND AVE STE 203 MIAMI SHORES, FL 33138 | AFLAC | $1 | $0 | $1 | 0.01% |
| TIMOTHY B ASBY3 | 11500 GOLDEN WILLOW CT ZIONSVILLE, IN 46077 | AFLAC | $1 | $0 | $1 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | DELTA DENTAL OF CALIFORNIA | $186 | $0 | $186 | 4.99% |
| IQBAL SINGH BAGGA3 | 10510 66TH AVE APT 5C FOREST HILLS, NY 11375 | AFLAC | $172 | $0 | $172 | 6.28% |
| RICHARD PETERSON3 | 19 IDLE DAY DR. CENTERPORT, NY 11721 | AFLAC | $47 | $0 | $47 | 1.72% |
| MARTIN F. CONROY3 | PO BOX 475 HOBOKEN, NJ 07030 | AFLAC | $46 | $0 | $46 | 1.68% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $19 | $0 | $19 | 0.69% |
| MERYL SURGAN3 | 326 JAEGER AVE MAYWOOD, NJ 07607 | AFLAC | $11 | $0 | $11 | 0.40% |
| JACQUES P DAVID CORPORATION3 | 5 MONFORT DR HUNTINGTON, NY 11743 | AFLAC | $8 | $0 | $8 | 0.29% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $5 | $0 | $5 | 0.18% |
| RUSSELL T BARRETT3 | 61 PORCUPINE CIR BALLSTON SPA, NY 12020 | AFLAC | $5 | $0 | $5 | 0.18% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $4 | $0 | $4 | 0.15% |
| DOMINICK R SIRACUSA3 | 225 DOLSON AVE STE 304 MIDDLETOWN, NY 10940 | AFLAC | $3 | $0 | $3 | 0.11% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 212 | $2.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 431 | $142K |
| Vision | VISION SERVICE PLAN | 163 | $28K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 0 | $110K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 0 | $110K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 0 | $110K |
| Other(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 18 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 431 | — |
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.