| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION | PO BOX 640 CAPITOLA, CA 95010 | CALIFORNIACHOICE | $61K | $0 | $61K | 5.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION | PO BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $60K | $7K | $67K | 16.65% |
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION CORP. | PO BOX 640 CAPITOLA, CA 95010 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.90% |
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION | PO BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $935 | $7K | 13.02% |
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION | 1500 41ST AVENUE, SUITE 228 CAPITOLA, CA 95010 | AFLAC | $2K | $0 | $2K | 13.03% |
| CYNTHIA MARIE HIDALGO3 | 3145 NUTMEG DRIVE CORONA, CA 92882 | AFLAC | $2K | $0 | $2K | 9.53% |
| KENNETH G. BARCLAY3 | 1218 VIA CANDELAS OCEANSIDE, CA 92056 | AFLAC | $643 | $0 | $643 | 3.80% |
| JONATHAN ALI HAJIMOMEN3 | 5752 WHISTLER CIRCLE HUNTINGTON BEACH, CA 92649 | AFLAC | $591 | $12 | $603 | 3.56% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 2824 SAINT ANDREWS ROAD FAIRFIELD, CA 94534 | AFLAC | $253 | $27 | $280 | 1.66% |
| PATRICIA ANN BOSCH3 Filed as: PATRICIA ANN BOSCH AND OTHER AGENTS | 6816 HOMAN COURT CHINO, CA 91710 | AFLAC | $224 | $31 | $255 | 1.51% |
| MICHAEL WEAVER3 | PO BOX 51422 MYRTLE BEACH, SC 29579 | AFLAC | $215 | $0 | $215 | 1.27% |
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION | PO BOX 640 CAPITOLA, CA 95010 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.54% |
| CAN INSURANCE SERVICES3 | PO BOX 640 CAPITOLA, CA 95010 | CALIFORNIA DENTAL NETWORK | $1K | $0 | $1K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WOODLAND HILLS, CA 91361 | CALIFORNIA DENTAL NETWORK | $531 | $0 | $531 | 5.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 Filed as: NAC INSURANCE ADMINISTRATION CORP. | PO BOX 640 CAPITOLA, CA 95010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 19.08% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 142 | $1.2M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 96 | $65K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 135 | $15K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $455K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $70K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $61K |
| Prescription drug | CALIFORNIACHOICE | 142 | $1.2M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $455K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.