| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | ANTHEM BLUE CROSS | $25K | — | $25K | 28.23% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS | — | $21K | $21K | 23.37% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | CONTINENTAL AMERICAN INSURANCE CO | $2K | — | $2K | 8.74% |
| ERICA GOLDEN3 | 430 W. HARVARD ST, APT C GLENDALE, CA 91204 | CONTINENTAL AMERICAN INSURANCE CO | $850 | — | $850 | 4.30% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | CONTINENTAL AMERICAN INSURANCE CO | $434 | — | $434 | 2.20% |
| VERONICA INCHAURREGUI3 | 800 WILSHIRE BLVD SUITE 200 LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE CO | $297 | — | $297 | 1.50% |
| STEVE SERVI3 | 6127 S. RAINBOW BLVD, 110 LAS VEGAS, NV 89118 | CONTINENTAL AMERICAN INSURANCE CO | $289 | — | $289 | 1.46% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS ST BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE CO | $242 | — | $242 | 1.22% |
| LUZ SERVI3 | 2349 SALEROS O DR UPLAND, CA 91748 | CONTINENTAL AMERICAN INSURANCE CO | $135 | — | $135 | 0.68% |
| CASS AND JOHANSING3 | 825 COLORADO BLVD, STE 215 LOS ANGELES, CA 90041 | CONTINENTAL AMERICAN INSURANCE CO | $111 | — | $111 | 0.56% |
| OSCAR FREGOSO3 | 340 E 2ND ST, STE 310 LOS ANGELES, CA 90012 | CONTINENTAL AMERICAN INSURANCE CO | $105 | — | $105 | 0.53% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1325 MT. HERMON RD, #73B SALISBURY, MD 21804 | CONTINENTAL AMERICAN INSURANCE CO | $81 | — | $81 | 0.41% |
| LILY FREGOSO3 | 3324 W. VERDUGO BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE CO | $76 | — | $76 | 0.38% |
| TODD V MASON3 Filed as: TODD V. MASON | 110 PINE AVE 3710 LONG BEACH, CA 90802 | CONTINENTAL AMERICAN INSURANCE CO | $68 | — | $68 | 0.34% |
| DORA BOSTICK3 | 1325 MT. HERMON RD SALISBURY, MD 21804 | CONTINENTAL AMERICAN INSURANCE CO | $61 | — | $61 | 0.31% |
| ELLEN G VALDEZ3 | 340 E. 2ND ST, STE 310 LOS ANGELES, CA 91604 | CONTINENTAL AMERICAN INSURANCE CO | $34 | — | $34 | 0.17% |
| ANNETTE L. BURNS3 Filed as: ANNETTE L BURNS | 28303 BRYCE DR CASTAIC, CA 91384 | CONTINENTAL AMERICAN INSURANCE CO | $25 | — | $25 | 0.13% |
| DAVID REESOR3 | 615 WILSON AVE UPLAND, CA 91784 | CONTINENTAL AMERICAN INSURANCE CO | $23 | — | $23 | 0.12% |
| JOANNA G MATHERLY3 Filed as: JOANNA G PEOPLE | 2000 GLEN ECHO RD, STE 204 NASHVILLE, TN 37215 | CONTINENTAL AMERICAN INSURANCE CO | $18 | — | $18 | 0.09% |
| NANETTE STARK3 | 11618 LA MAIDA ST NORTH HOLLYWOOD, CA 91601 | CONTINENTAL AMERICAN INSURANCE CO | $18 | — | $18 | 0.09% |
| MAX-JOSEPH H MONTEL3 | 948 WILCOX AVE 34 LOS ANGELES, CA 90038 | CONTINENTAL AMERICAN INSURANCE CO | $15 | — | $15 | 0.08% |
| GLADYS N VIDES3 | 6055 E. WASHINGTON BLVD,#460 COMMERCE, CA 91722 | CONTINENTAL AMERICAN INSURANCE CO | $13 | — | $13 | 0.07% |
| RAVONE M GRAHAM3 | 5329 PASEO GILBERTO YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE CO | $12 | — | $12 | 0.06% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS, INC | 12121 WILSHIRE BLVD, STE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE CO | $10 | — | $10 | 0.05% |
| LABAN M. SPALDING3 Filed as: LABAN M SPALDING | 4297 KLUME AVE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE CO | $9 | — | $9 | 0.05% |
| KENNETH B MCPHERSON3 | 3 ROSELEAF IRVINE, CA 92620 | CONTINENTAL AMERICAN INSURANCE CO | $6 | — | $6 | 0.03% |
| FRANSOISE Y KORENBERG3 | 6055 E. WASHINGTON BLVD, STE 460 COMMERCE, CA 90040 | CONTINENTAL AMERICAN INSURANCE CO | $6 | — | $6 | 0.03% |
| OWEN JOHNSTON3 | 796 N. HART ST ORANGE, CA 92867 | CONTINENTAL AMERICAN INSURANCE CO | $3 | — | $3 | 0.02% |
| HERACLIO ORTIZ3 | 26015 CYPRESS ST, 41 LOMITA, CA 90717 | CONTINENTAL AMERICAN INSURANCE CO | $2 | — | $2 | 0.01% |
| LIVIER MARIA RAMIREZ3 Filed as: LIVIER RAMIREZ | 2101 TOLDEDO ST LOS ANGELES, CA 90042 | CONTINENTAL AMERICAN INSURANCE CO | $2 | — | $2 | 0.01% |
| OWEN JOHNSTON3 | 796 N. HART ST ORANGE, CA 92867 | CONTINENTAL AMERICAN INSURANCE CO | $0 | — | $0 | 0.00% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 2881 NE 32ND ST FT. LAUDERDALE, FL 33306 | CONTINENTAL AMERICAN INSURANCE CO | $0 | — | $0 | 0.00% |
| NANCY CALDERON3 | 6210 BEAR AVE BELL, CA 90201 | CONTINENTAL AMERICAN INSURANCE CO | $0 | — | $0 | 0.00% |
| ERICA GOLDEN3 | 430 HARVARD ST, APT C GLENDALE, CA 91204 | AFLAC | $235 | — | $235 | 4.21% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | AFLAC | $178 | — | $178 | 3.19% |
| VERONICA INCHAURREGUI3 | 5784 ROOSEVELT AVE SOUTH GATE, CA 90280 | AFLAC | $106 | — | $106 | 1.90% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | AFLAC | $99 | — | $99 | 1.77% |
| DORA BOSTICK3 | 1620 DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $99 | — | $99 | 1.77% |
| LILY FREGOSO3 | 25750 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $40 | — | $40 | 0.72% |
| CARLA BAGDASARYAN3 | 2879 W. MIRA DRIVE QUEEN CREEK, AZ 85142 | AFLAC | $4 | — | $4 | 0.07% |
| ELLEN G VALDEZ3 | 20016 BLYTHE ST WINNETKA, CA 91306 | AFLAC | $0 | — | $0 | 0.00% |
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 | 84 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 84 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CA | 69 | $436K |
| Dental | ANTHEM BLUE CROSS | 84 | $90K |
| Vision | ANTHEM BLUE CROSS | 84 | $90K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 298 | $110K |
| Long-term disability | ANTHEM BLUE CROSS | 84 | $90K |
| Prescription drug | BLUE CROSS OF CA | 69 | $436K |
| Other | AFLAC | 10 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.