| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | ANTHEM BLUE CROSS | $35K | — | $35K | 72.93% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS | — | $15K | $15K | 31.15% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | CONTINENTAL AMERICAN INSURANCE CO | $4K | — | $4K | 9.83% |
| VERONICA INCHAURREGUI3 | 800 WILSHIRE BLVD SUITE 200 COMPTON, CA 90221 | CONTINENTAL AMERICAN INSURANCE CO | $1K | — | $1K | 4.05% |
| ERICA GOLDEN3 | 430 W. HARVARD ST, APT C GLENDALE, CA 91204 | CONTINENTAL AMERICAN INSURANCE CO | $780 | — | $780 | 2.13% |
| DORA BOSTICK3 | 1325 MT. HERMON RD SALISBURY, MD 21804 | CONTINENTAL AMERICAN INSURANCE CO | $546 | — | $546 | 1.49% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | CONTINENTAL AMERICAN INSURANCE CO | $483 | — | $483 | 1.32% |
| RHOEL T VALDEZ3 | 340 E. 2ND ST 310 LOS ANGELES, CA 90012 | CONTINENTAL AMERICAN INSURANCE CO | $354 | — | $354 | 0.96% |
| STEVE SERVI3 | 6127 S. RAINBOW BLVD, 110 LAS VEGAS, NV 89118 | CONTINENTAL AMERICAN INSURANCE CO | $324 | — | $324 | 0.88% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA LEES | 1124 CHURCHS ST BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE CO | $252 | — | $252 | 0.69% |
| LUZ SERVI3 | 2349 SALEROSO DR ROWLAND HEIGHTS, CA 91748 | CONTINENTAL AMERICAN INSURANCE CO | $180 | — | $180 | 0.49% |
| CASS AND JOHANSING3 | 825 COLORADO BLVD, STE 215 LOS ANGELES, CA 90041 | CONTINENTAL AMERICAN INSURANCE CO | $120 | — | $120 | 0.33% |
| LILY FREGOSO3 | 3324 W. VERDUGO BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE CO | $106 | — | $106 | 0.29% |
| TODD V MASON3 Filed as: TODD V. MASON | 110 PINE AVE 3710 LONG BEACH, CA 90802 | CONTINENTAL AMERICAN INSURANCE CO | $74 | — | $74 | 0.20% |
| SIRANOUSH SARA MKRTCHIAN3 Filed as: SIRANOUSH S MKRTCHIAN | 2001 FINANCIAL WAY #200 GLENDORA, CA 91741 | CONTINENTAL AMERICAN INSURANCE CO | $46 | — | $46 | 0.13% |
| OSCAR FREGOSO3 | 340 E 2ND ST, STE 310 LOS ANGELES, CA 90012 | CONTINENTAL AMERICAN INSURANCE CO | $44 | — | $44 | 0.12% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1325 MT. HERMON RD, #73B SALISBURY, MD 21804 | CONTINENTAL AMERICAN INSURANCE CO | $44 | — | $44 | 0.12% |
| ELLEN G VALDEZ3 | 340 E 2ND ST#310 LOS ANGELES, CA 91604 | CONTINENTAL AMERICAN INSURANCE CO | $42 | — | $42 | 0.11% |
| ELLEN G VALDEZ3 | 340 E. 2ND ST, STE 310 LOS ANGELES, CA 91604 | CONTINENTAL AMERICAN INSURANCE CO | $41 | — | $41 | 0.11% |
| DAVID REESOR3 | 615 WILSON AVE UPLAND, CA 91784 | CONTINENTAL AMERICAN INSURANCE CO | $21 | — | $21 | 0.06% |
| JOANNA G MATHERLY3 Filed as: JOANNA G PEOPLE | 2000 GLEN ECHO RD, STE 204 NASHVILLE, TN 37215 | CONTINENTAL AMERICAN INSURANCE CO | $20 | — | $20 | 0.05% |
| NANETTE STARK3 | 11618 LA MAIDA ST NORTH HOLLYWOOD, CA 91601 | CONTINENTAL AMERICAN INSURANCE CO | $13 | — | $13 | 0.04% |
| NANETTE STARK3 | 11618 LA MAIDA ST NORTH HOLLYWOOD, CA 91601 | CONTINENTAL AMERICAN INSURANCE CO | $13 | — | $13 | 0.04% |
| MAX-JOSEPH H MONTEL3 | 948 WILCOX AVE 34 LOS ANGELES, CA 90038 | CONTINENTAL AMERICAN INSURANCE CO | $10 | — | $10 | 0.03% |
| RAVONE M GRAHAM3 | 5329 PASEO GILBERTO YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE CO | $10 | — | $10 | 0.03% |
| FRANSOISE Y KORENBERG3 | 6055 E. WASHINGTON BLVD, STE 460 COMMERCE, CA 90040 | CONTINENTAL AMERICAN INSURANCE CO | $8 | — | $8 | 0.02% |
| CARLA BAGDASARYAN3 Filed as: CARLA J BAGDASARYAN | 316 W 2ND #500 LOS ANGELES, CA 90012 | CONTINENTAL AMERICAN INSURANCE CO | $7 | — | $7 | 0.02% |
| LABAN M. SPALDING3 Filed as: LABAN M SPALDINR | 4297 KLUME AVE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE CO | $6 | — | $6 | 0.02% |
| OWEN JOHNSTON3 | 796 N. HART ST ORANGE, CA 92867 | CONTINENTAL AMERICAN INSURANCE CO | $3 | — | $3 | 0.01% |
| ANNETTE L. BURNS3 Filed as: ANNETTE L BURNS | 28303 BRYCE DR CASTAIC, CA 91384 | CONTINENTAL AMERICAN INSURANCE CO | $2 | — | $2 | 0.01% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS, INC | 12121 WILSHIRE BLVD, STE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE CO | $1 | — | $1 | 0.00% |
| VERONICA INCHAURREGUI3 | 800 WILSHIRE BLVD, STE 200 COMPTON, CA 90221 | AFLAC | $252 | — | $252 | 5.62% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | AFLAC | $180 | — | $180 | 4.02% |
| DORA BOSTICK3 | 1325 MT HERMON RD #73B SALISBURY, MD 21804 | AFLAC | $157 | — | $157 | 3.50% |
| ERICA GOLDEN3 | 430 HARVARD ST, APT C GLENDALE, CA 91204 | AFLAC | $116 | — | $116 | 2.59% |
| RHOEL T VALDEZ3 | 20016 BLYTHE ST WINNETKA, CA 91306 | AFLAC | $57 | — | $57 | 1.27% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | AFLAC | $55 | — | $55 | 1.23% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1325 MT HERMON, #73B SALISBURY, MD 21804 | AFLAC | $10 | — | $10 | 0.22% |
| LILY FREGOSO3 | 25750 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $9 | — | $9 | 0.20% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CA | 108 | $707K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CA | 109 | $754K |
| Vision | ANTHEM BLUE CROSS | 109 | $48K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 109 | $52K |
| Long-term disability | ANTHEM BLUE CROSS | 109 | $48K |
| Prescription drug | BLUE CROSS OF CA | 108 | $707K |
| Other | CONTINENTAL AMERICAN INSURANCE CO | 38 | $37K |
| 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.