| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | CALIFORNIACHOICE | $45K | — | $45K | 4.98% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $214 | $5K | 13.38% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $273 | $1K | 4.95% |
| CALNONPROFITS INSURANCE SERVICES3 | P O BOX 640 CAPITOLA, CA 95010 | CALIFORNIA DENTAL NETWORK | $1K | — | $1K | 10.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.16% |
| PATRICIA ANN BOSCH | 6816 HOMAN CT. CHINO, CA 91710 | AFLAC | $2K | — | $2K | 22.20% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | AFLAC | $1K | — | $1K | 14.80% |
| JOY E GUNDERSON Filed as: JOY GUNDERSON | 4531 VALLECITO LN YORBA LINDA, CA 92886 | AFLAC | $491 | — | $491 | 5.63% |
| JONATHAN ALI HAJIMOMEN | 6540 GRAND MANAN DR. CYPRESS, CA 90630 | AFLAC | $467 | — | $467 | 5.36% |
| JOY E GUNDERSON Filed as: JOY GUNDERSON | 2144 DENA DR. CONCORD, CA 94519 | AFLAC | $202 | — | $202 | 2.32% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $979 | $114 | $1K | 16.74% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $637 | — | $637 | 11.73% |
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 | 109 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 107 | $906K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 79 | $42K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 94 | $12K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $45K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $48K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $44K |
| Prescription drug | CALIFORNIACHOICE | 107 | $906K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.