| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | CIGNA | $41K | $3K | $44K | 3.58% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD AND BROWN | 721 S. PARKER SUITE 300 ORANGE, CA 92868 | CIGNA | $0 | $26K | $26K | 2.09% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | SUNLIFE ASSURANCE CO OF CANADA | $3K | — | $3K | 13.30% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | SUNLIFE ASSURANCE CO OF CANADA | $986 | — | $986 | 4.57% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | CONTINENTAL AMERICAN INSURANCE CO | $2K | — | $2K | 9.55% |
| VERONICA INCHAURREGUI3 | 521 S ESSEY AVE COMPTON, CA 90221 | CONTINENTAL AMERICAN INSURANCE CO | $2K | — | $2K | 9.44% |
| ERICA RUTH GOLDEN3 | 810 S FLOWER ST APT 612 LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE CO | $656 | — | $656 | 3.79% |
| DORA BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | CONTINENTAL AMERICAN INSURANCE CO | $583 | — | $583 | 3.37% |
| RHOEL T VALDEZ3 Filed as: RHOEL TELMO VALDEZ | 20016 BLYTHE ST WINNETKA, CA 91306 | CONTINENTAL AMERICAN INSURANCE CO | $581 | — | $581 | 3.36% |
| MICHELLE ANN DERAS3 | PO BOX 365 WEST COVINA, CA 91793 | CONTINENTAL AMERICAN INSURANCE CO | $270 | — | $270 | 1.56% |
| STEVE D SERVI3 Filed as: STEVE DAVID SERVI | 6127 S RAINBOW BLVD 110 LAS VEGAS, NV 89118 | CONTINENTAL AMERICAN INSURANCE CO | $205 | — | $205 | 1.19% |
| PATRICIA GAIL LEES3 | 1124 CHURCHS COURT BURBANK, CA 91501 | CONTINENTAL AMERICAN INSURANCE CO | $170 | — | $170 | 0.98% |
| ERICA GOLDEN3 | 810 S FLOWER ST APT 612 LOS ANGELES, CA 90017 | CONTINENTAL AMERICAN INSURANCE CO | $123 | — | $123 | 0.71% |
| SIRANOUSH SARA MKRTCHIAN3 | 11014 LORENE ST WHITTIER, CA 90601 | CONTINENTAL AMERICAN INSURANCE CO | $107 | — | $107 | 0.62% |
| LILY FREGOSO3 | 3607 W. CLARK AVE BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE CO | $70 | — | $70 | 0.40% |
| TODD VICTOR MASON3 | 318 BROADMOOR WAY MCDONOUGH, GA 30253 | CONTINENTAL AMERICAN INSURANCE CO | $49 | — | $49 | 0.28% |
| OSCAR FREGOSO3 | 3607 W. CLARK AVE BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE CO | $39 | — | $39 | 0.23% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1620 S DITMAR ST OCEANSIDE, CA 92054 | CONTINENTAL AMERICAN INSURANCE CO | $37 | — | $37 | 0.21% |
| DAVID JOHN REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | CONTINENTAL AMERICAN INSURANCE CO | $14 | — | $14 | 0.08% |
| JOANNA G MATHERLY3 Filed as: JOANNA GRACE MATHERLY | 4581 MAJESTIC MEADOWS DR ARRINGTON, TN 37014 | CONTINENTAL AMERICAN INSURANCE CO | $12 | — | $12 | 0.07% |
| RAVONE M GRAHAM3 | 5329 PASEO GILBERTO YORBA LINDA, CA 92886 | CONTINENTAL AMERICAN INSURANCE CO | $8 | — | $8 | 0.05% |
| FRANCOISE YVONNE KORENBERG3 | 156 N ORANGE DR LOS ANGELES, CA 90036 | CONTINENTAL AMERICAN INSURANCE CO | $6 | — | $6 | 0.03% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | CONTINENTAL AMERICAN INSURANCE CO | $5 | — | $5 | 0.03% |
| OWEN CONRAD JOHNSTON3 | 2700 PETERSON PLACE 65C COSTA MESA, CA 92626 | CONTINENTAL AMERICAN INSURANCE CO | $2 | — | $2 | 0.01% |
| CASS AND JOHANSING3 | 177 E. COLORADO BLVD 2ND FLOOR PASADENA, CA 91105 | CONTINENTAL AMERICAN INSURANCE CO | $2 | — | $2 | 0.01% |
| DALE IRA DAVIS3 | 333 E SHORT ST SUITE 130 LEXINGTON, KY 40507 | CONTINENTAL AMERICAN INSURANCE CO | $1 | — | $1 | 0.01% |
| VERONICA INCHAURREGUI3 | 521 S ESSEY AVE COMPTON, CA 90221 | AFLAC | $186 | $63 | $249 | 3.98% |
| BB&H BENEFIT DESIGNS3 | 109 E. VICTORIA ST SANTA BARBARA, CA 93101 | AFLAC | $222 | — | $222 | 3.55% |
| ERICA GOLDEN3 | PO BOX 811094 LOS ANGELES, CA 90081 | AFLAC | $98 | — | $98 | 1.57% |
| DORA BOSTICK3 | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $86 | — | $86 | 1.37% |
| RHOEL T VALDEZ3 Filed as: RHOEL VALDEZ | 20016 BLYTHE WINNETKA, CA 91306 | AFLAC | $68 | $15 | $83 | 1.33% |
| SIRANOUSH SARA MKRTCHIAN3 Filed as: SIRANOUSH SARA MRKTCHIAN | 11014 LORENE ST WHITTIER, CA 90601 | AFLAC | $58 | $15 | $73 | 1.17% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 43 MILL TOWN LOOP STE C BOZEMAN, MT 59718 | AFLAC | $45 | — | $45 | 0.72% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $10 | — | $10 | 0.16% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 124 | $1.2M |
| Dental | CIGNA | 124 | $1.2M |
| Vision | CIGNA | 124 | $1.2M |
| Life insurance(2 contracts, 2 carriers) | SUNLIFE ASSURANCE CO OF CANADA | 138 | $28K |
| Long-term disability | SUNLIFE ASSURANCE CO OF CANADA | 138 | $22K |
| Prescription drug | CIGNA | 124 | $1.2M |
| Other | CONTINENTAL AMERICAN INSURANCE CO | 34 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.