| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOMENTOUS INSURANCE BROKERAGE, INC.3 Filed as: MOMENTOUS INSURANCE BROKERAGE INC. | 5990 SEPULVEDA BLVD. 550 VAN NUYS, CA 91411 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $72K | $6K | $78K | 3.47% |
| MOMENTOUS INSURANCE BROKERAGE, INC.3 Filed as: MOMENTOUS INSURANCE BROKERAGE | 5990 SEPULVEDA BLVD. STE 550 VAN NUYS, CA 91411 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 15.00% |
| AVANT-GARDE INSURANCE SOLUTIONS3 Filed as: AVANT GRADE INSURANCE SOLUTIONS | 2910 NEILSON WAY UNIT 410 SANTA MONICA, CA 90405 | AFLAC | $1K | — | $1K | 7.55% |
| MOMENTOUS INSURANCE BROKERAGE, INC.3 Filed as: MOMENTOUS INSURANCE BROKERAGE INC. | 5990 SEPULVEDA BLVD. STE 700 - 740 SHERMAN OAKS, CA 91411 | AFLAC | $628 | — | $628 | 3.30% |
| RENEE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD. STE 700-740 SHERMAN OAKS, CA 91411 | AFLAC | $462 | — | $462 | 2.42% |
| RICHARD J KUNZ3 Filed as: RICHARD KUNZ | 351 CALIFORNIA ST. STE 450 SAN FRANCISCO, CA 94104 | AFLAC | $263 | — | $263 | 1.38% |
| RUSSELL L WARYE3 Filed as: RUSSELL NAKAMURA | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $139 | — | $139 | 0.73% |
| AMY EVANS3 | 14358 MAGNOLIA BLVD. APT #103 SHERMAN OAKS, CA 91423 | AFLAC | $86 | — | $86 | 0.45% |
| ADAM H MICHAELS3 Filed as: ADAM MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | AFLAC | $71 | — | $71 | 0.37% |
| DEWITT STERN OF CALIFORNIA LLC3 | 801 N BRAND BLVD STE 650 GLENDALE, CA 91203 | AFLAC | $52 | — | $52 | 0.27% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST. FT LAUDERDALE, FL 33308 | AFLAC | $47 | — | $47 | 0.25% |
| BRIAN GEORGE JAEGGI3 Filed as: BRIAN JAEGGI | 15607 W LILLI WAY VAN NUYS, CA 91406 | AFLAC | $43 | — | $43 | 0.23% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH BUZZELLO | 9018 BALBOA BLVD STE 254 NORTHRIDGE, CA 91325 | AFLAC | $30 | — | $30 | 0.16% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE. LOS ANGELES, CA 90045 | AFLAC | $17 | — | $17 | 0.09% |
| MICHAEL C WALKER3 Filed as: MICHAEL STACHOWIAK | 321 N CLARK ST. STE 625 CHICAGO, IL 60654 | AFLAC | $14 | — | $14 | 0.07% |
| MICHAEL R. FISHER3 Filed as: MICHAEL FISHER | 3201 WILSHIRE BLVD STE 102 SANTA MONICA, CA 90403 | AFLAC | $8 | — | $8 | 0.04% |
| JOSHEPH BUZZELLO3 | 9018 BALBOA BLVD STE 254 NORTHRIDGE, CA 91325 | AFLAC | $4 | — | $4 | 0.02% |
| LARA K GRANDE3 | 1022 WESTHEAVEN BLVD FRANKLIN, TN 37064 | AFLAC | $2 | — | $2 | 0.01% |
| OLENA K SHEA3 | 3 MITCHELL PLACE UNIT 18C NEW YORK, NY 10017 | AFLAC | $1 | — | $1 | 0.01% |
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 | 351 | 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) | 351 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 351 | $2.3M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 351 | $2.3M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 351 | $2.3M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 351 | $2.3M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 168 | $127K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 351 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.