| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SERVICES | 24005 VENTURA BLVD. CALABASAS, CA 91302 | BLUE CROSS OF CALIFORNIA | $47K | $23K | $70K | 7.43% |
| DANONE SIMPSON INSURANCE SERVICES3 | 24005 VENTURA BLVD. CALABASAS, CA 91302 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $16K | $13K | $29K | 15.82% |
| ANNETTE L. BURNS3 Filed as: ANNETTE L BURNS | 28303 BRYCE DR CASTAIC, CA 91384 | AFLAC | $1K | $0 | $1K | 3.90% |
| JACOB BURNS INC.3 | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | AFLAC | $1K | $0 | $1K | 3.70% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 511 SANTA MONICA, CA 90406 | AFLAC | $359 | $0 | $359 | 0.98% |
| GEORGE E ARBID3 | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $324 | $0 | $324 | 0.89% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SVCS LLC | 22110 CLARENDON ST SUITE 201 WOODLAND HILLS, CA 91367 | AFLAC | $284 | $0 | $284 | 0.78% |
| JACOB BURNS INC.3 Filed as: JACOB M BURNS | 12121 WILSHIRE BLVD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $151 | $0 | $151 | 0.41% |
| OLENA K SHEA3 | 3 MITCHELL PL UNIT 18C NEW YORK, NY 10017 | AFLAC | $131 | $0 | $131 | 0.36% |
| WOOD GUTMANN & BOGART INSURANCE3 Filed as: WOOD GUTMANN & BOGART INS BROKERS | 15901 RED HILL AVE SUITE 100 TUSTIN, CA 92780 | AFLAC | $117 | $0 | $117 | 0.32% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS | 1920 MAIN STREET SUITE 600 IRVINE, CA 92614 | AFLAC | $70 | $0 | $70 | 0.19% |
| RENE CASTRO3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $69 | $0 | $69 | 0.19% |
| JENNY ROSENBAUM3 Filed as: JENNY A ROSENBAUM | 21 TROFELLO LN ALISO VIEJO, CA 92656 | AFLAC | $63 | $0 | $63 | 0.17% |
| JAIME PUERTA3 Filed as: JAIME I PUERTA | 28443 SANTA CATARINA RD SANTA CLARITA, CA 91350 | AFLAC | $59 | $0 | $59 | 0.16% |
| ADAM H MICHAELS3 | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $53 | $0 | $53 | 0.15% |
| SHERRI D PERRY3 | 5151 WOODMAN AVE APT 41 SHERMAN OAKS, CA 91423 | AFLAC | $46 | $0 | $46 | 0.13% |
| HORACIO J. LANZAS3 Filed as: HORACIO J LANZAS | 7032 BAIRD AVE RESEDA, CA 91335 | AFLAC | $44 | $0 | $44 | 0.12% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $40 | $0 | $40 | 0.11% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD. SANTA ANA, CA 92704 | AFLAC | $35 | $0 | $35 | 0.10% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN ALI HAMJIMOMEN | 6540 GRAND MANAN DR CYPRESS, CA 90630 | AFLAC | $26 | $0 | $26 | 0.07% |
| TOMMY L JOHNSON JR3 | 711 S OLIVE STREET APT 314 LOS ANGELES, CA 90014 | AFLAC | $23 | $0 | $23 | 0.06% |
| GEOFFREY MALAIS3 | PO BOX 280-717 NORTHRIDGE, CA 91328 | AFLAC | $23 | $0 | $23 | 0.06% |
| MARSHALL CHARLES MCDONALD3 | 17031 SUMMERS WALK BLVD. DAVIDSON, NC 28036 | AFLAC | $20 | $0 | $20 | 0.05% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE LOS ANGELES, CA 90045 | AFLAC | $15 | $0 | $15 | 0.04% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $14 | $0 | $14 | 0.04% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R FISHER | 50 W LEMON AVE SUITE 2 MONROVIA, CA 91016 | AFLAC | $12 | $0 | $12 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST SUITE 615 CHICAGO, IL 60654 | AFLAC | $10 | $0 | $10 | 0.03% |
| DAVID BRYANT3 | 1925 CENTURY PARK E SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $10 | $0 | $10 | 0.03% |
| ELIZABETH MICAELA VEGA3 | 11671 STRATHERN STREET NORTH HOLLYWOOD, CA 91605 | AFLAC | $8 | $0 | $8 | 0.02% |
| KATRINA LAFATA3 | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | AFLAC | $6 | $0 | $6 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H WILLIS JR | 1431 NE 55TH STREET FORT LAUDERDALE, FL 33334 | AFLAC | $3 | $0 | $3 | 0.01% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $3 | $0 | $3 | 0.01% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 728 MERCER PL HUNTERSVILLE, NC 28078 | AFLAC | $2 | $0 | $2 | 0.01% |
| DAWN A CHRISTENSEN3 | 24516 APPLE STREET NEWHALL, CA 91321 | AFLAC | $1 | $0 | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $1 | $0 | $1 | 0.00% |
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 | 230 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 271 | $948K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 283 | $185K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 283 | $185K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 283 | $185K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 283 | $185K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 283 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.