| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC | $17K | $0 | $17K | 3.92% |
| J.D. GILMOUR & CO., INC.3 Filed as: J D GILMOUR & CO INC | 300 W GLENOAKS BLVD SUITE 301 GLENDALE, CA 91202 | BLUE SHIELD OF CALIFORNIA | $0 | $18K | $18K | 5.26% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUTE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 15.00% |
| SABRINA CAMPAGNA3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $2K | $193 | $3K | 8.00% |
| RENNE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $650 | $35 | $685 | 2.18% |
| RUBEN ROSA3 | 5307 SEPULVEDA BLVD APT 118 SHERMAN OAKS, CA 91411 | AFLAC | $601 | $35 | $636 | 2.03% |
| SVETLANA MAGILNER3 | 2000 NORTH BAYSHORE DR APT 510 MIAMI, FL 33137 | AFLAC | $423 | $0 | $423 | 1.35% |
| ROSARIO RONQUILLO3 | 4500 PARK GRANADA STE 202 CALABASAS, CA 91302 | AFLAC | $360 | $0 | $360 | 1.15% |
| CHRISTOPHER UNDERWOOD3 Filed as: CHRISTOPHER MATTHEW PORTEOUS | 15323 WEDDINGTON ST APT 304 SHERMAN OAKS, CA 91411 | AFLAC | $11 | $0 | $11 | 0.04% |
| ABRAMS MARKETING INC3 | 9538 W PICO BLVD LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 11.47% |
| INOCENCIA MAY CRAWFORD3 | PO BOX 3721 RANCHO CUCAMONGA, CA 91729 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $948 | $0 | $948 | 3.62% |
| TERI ROLLIN3 | C/O TERI ROLLIN OAK PARK, CA 91377 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $207 | $0 | $207 | 0.79% |
| TAMARA DENISE CHEZICK3 | 166 EAST GARDEN GREEN HUENENE, CA 93041 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 0.24% |
| CHARLOTTE MARTINEZ3 Filed as: CHARLOTTE ANNE MARTINEZ | 70100 MIRAGE COVE DR RANCHO MIRAGE, CA 92270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.06% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 9795 GATEWAY DR RENO, NV 89521 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.03% |
| JOHN M. GILMOUR, INC.3 Filed as: JOHN M GILMOUR INC | 300 W GLENOAKS BLVD SUITE 301 GLENDALE, CA 91202 | SAFEGUARD HEALTH PLANS, INC. | $1K | $0 | $1K | 10.03% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUTE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $694 | $0 | $694 | 14.99% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET 110 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE | $245 | $0 | $245 | 9.84% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUTE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $269 | $0 | $269 | 15.01% |
| SABRINA CAMPAGNA3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $361 | $54 | $415 | 26.76% |
| RUBEN ROSA3 | 5307 SEPULVEDA BLVD APT 118 SHERMAN OAKS, CA 91411 | AFLAC | $93 | $11 | $104 | 6.71% |
| RENNE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $57 | $11 | $68 | 4.38% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 50 | $781K |
| Dental | SAFEGUARD HEALTH PLANS, INC. | 37 | $12K |
| Vision | EYEMED VISION CARE | 36 | $2K |
| Life insurance(5 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $93K |
| Short-term disability(3 contracts, 2 carriers) | AFLAC | 38 | $59K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 111 | $5K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 40 | $336K |
| Other(4 contracts, 3 carriers) | AFLAC | 111 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.