| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $95K | $1K | $96K | 5.40% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $19K | $0 | $19K | 4.97% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES L | 2677 N MAIN ST SUITE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 1.99% |
| PCF INSURANCE SERVICES OF THE WEST | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA SUPPLEMENTAL HEALTH SOLUTIONS | $955 | $242 | $1K | 20.46% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA SUPPLEMENTAL HEALTH SOLUTIONS | $872 | $268 | $1K | 20.73% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA SUPPLEMENTAL HEALTH SOLUTIONS | $825 | $288 | $1K | 22.35% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $592 | $0 | $592 | 14.99% |
| LINDA M NAPOLI3 Filed as: LINDA NAPOLI | 17631 VENTURA BLVD 321 ENCINO, CA 91316 | AFLAC | $665 | $184 | $849 | — |
| PATRICIA GAIL LEES3 | 1124 CHURCHS CT BURBANK, CA 91501 | AFLAC | $486 | $15 | $501 | — |
| TRUCORDIA INSURANCE SERVICES LLC3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | AFLAC | $336 | $0 | $336 | — |
| MICHELE A UNDERELL3 | 3682 TAFT CT WHEAT RIDGE, CO 80033 | AFLAC | $234 | $0 | $234 | — |
| MARY ELLEN G PERSONS3 | 2747 HERMOSA AVE APT 5 MONTROSE, CA 91020 | AFLAC | $177 | $0 | $177 | — |
| RHOEL T VALDEZ3 | 20016 BYTHE ST WINNETKA, CA 91306 | AFLAC | $117 | $13 | $130 | — |
| DAVID J REESOR3 | 1615 WILSON AVE UPLAND, CA 91784 | AFLAC | $81 | $0 | $81 | — |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1620 S DITMAR ST OCEANSIDE, CA 92054 | AFLAC | $35 | $0 | $35 | — |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $18 | $0 | $18 | — |
| MJR INSURANCE SERVICES LLC3 | 10609 WOODBRIDGE ST NORTH HOLLYWOOD, CA 91602 | AFLAC | $18 | $0 | $18 | — |
| ROBERT D TURNER3 Filed as: ROBERT MILER QUICK | 8690 AERO DR SUITE 115 SAN DIEGO, CA 92123 | AFLAC | $15 | $0 | $15 | — |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH R BUZZELLO | 14747 N NORTHSIGHT BLVD SUITE 111 4 SCOTTSDATE, AZ 85260 | AFLAC | $9 | $0 | $9 | — |
| L MATTHEWS SPALDING3 | 847 N HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | AFLAC | $9 | $0 | $9 | — |
| TODD V MASON | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $5 | $0 | $5 | — |
| JOANNA G MATHERLY3 | 4581 MAJESTIC MEADOWS DR ARRINGTON, TN 37104 | AFLAC | $2 | $0 | $2 | — |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $1 | $0 | $1 | — |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE ST TOLUCA LAKE, CA 91602 | AFLAC | $1 | $0 | $1 | — |
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 | 176 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $1.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $1.8M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $53K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 68 | $13K |
| Other(7 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 170 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.