| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | BLUE CROSS OF CALIFORNIA | $61K | $0 | $61K | 3.48% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN., INC. | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $0 | $35K | $35K | 2.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS CORP. | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | BLUE CROSS OF CALIFORNIA | $24K | $0 | $24K | 1.37% |
| ACRISURE LLC3 Filed as: LBW INSURANCE & FINANCIAL SERVICES | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $136 | $6K | 13.76% |
| ACRISURE LLC5 Filed as: LBW INSURANCE & FINANCIAL SERVICE | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 7.15% |
| ANNETTE L. BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $823 | $0 | $823 | 4.90% |
| HORACIO J. LANZAS3 Filed as: HORACIO J. LANZAS AND OTHER AGENTS | 7032 BAIRD AVENUE RESEDA, CA 91335 | AFLAC | $317 | $0 | $317 | 1.89% |
| ALKEME INSURANCE SERVICES INC3 Filed as: ALKEME INSURANCE SERVICES, INC. | 111 CORPORATE DRIVE, SUITE 200 LADERA RANCH, CA 92694 | AFLAC | $261 | $0 | $261 | 1.55% |
| JAIME PUERTA3 Filed as: JAIME I. PUERTA | 28443 SANTA CATARINA ROAD SANTA CLARITA, CA 91350 | AFLAC | $162 | $0 | $162 | 0.96% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS, INC. | 2905 MAGNOLIA AVENUE LONG BEACH, CA 90806 | AFLAC | $149 | $0 | $149 | 0.89% |
| GEORGE E ARBID3 Filed as: GEORGE E. ARBID | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $82 | $0 | $82 | 0.49% |
| VICTOR M FLORES3 Filed as: VICTOR M. FLORES | 1815 BRENNAN COURT LANCASTER, CA 93534 | AFLAC | $69 | $0 | $69 | 0.41% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 185 | $1.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 185 | $1.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 185 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $59K |
| Short-term disability | AFLAC | 21 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $42K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 185 | $1.8M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 185 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.
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.