| 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 | $65K | $2K | $67K | 5.66% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SERV LLC | 24005 VENTURA BLVD. CALABASAS, CA 91302 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $18K | $0 | $18K | 8.86% |
| ANNETTE L. BURNS3 Filed as: ANNETTE L BURNS | 28303 BRYCE DR CASTAIC, CA 91384 | AFLAC | $2K | $57 | $2K | 5.63% |
| JACOB BURNS INC.3 | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | AFLAC | $1K | $35 | $1K | 3.02% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 511 SANTA MONICA, CA 90406 | AFLAC | $286 | $0 | $286 | 0.82% |
| GEORGE E ARBID3 | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $214 | $21 | $235 | 0.67% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS | 12121 WILSHIRE BLVD STE 1000 LOS ANGELES, CA 90025 | AFLAC | $164 | $45 | $209 | 0.60% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SVCS LLC | 22110 CLARENDON ST SUITE 201 WOODLAND HILLS, CA 91367 | AFLAC | $150 | $0 | $150 | 0.43% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R FISHER | 50 W LEMON AVE STE 2 MONROVIA, CA 91016 | AFLAC | $137 | $0 | $137 | 0.39% |
| JACOB BURNS INC.3 Filed as: JACOB M BURNS | 12121 WILSHIRE BLVD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $121 | $13 | $134 | 0.38% |
| OLENA K SHEA3 | 3 MITCHELL PL UNIT 18C NEW YORK, NY 10017 | AFLAC | $117 | $0 | $117 | 0.34% |
| WOOD GUTMANN & BOGART INSURANCE3 Filed as: WOOD GUTMANN & BOGART INS BROKERS | 15901 RED HILL AVE SUITE 100 TUSTIN, CA 92780 | AFLAC | $93 | $0 | $93 | 0.27% |
| RENE CASTRO3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $69 | $0 | $69 | 0.20% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS | 2010 MAIN ST SUITE 700 IRVINE, CA 92614 | AFLAC | $66 | $0 | $66 | 0.19% |
| JENNY ROSENBAUM3 Filed as: JENNY A ROSENBAUM | 21 TROFELLO LN ALISO VIEJO, CA 92656 | AFLAC | $63 | $0 | $63 | 0.18% |
| JAIME PUERTA3 Filed as: JAIME I PUERTA | 28443 SANTA CATARINA RD SANTA CLARITA, CA 91350 | AFLAC | $59 | $0 | $59 | 0.17% |
| ADAM H MICHAELS3 | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $52 | $0 | $52 | 0.15% |
| SHERRI D PERRY3 | 5151 WOODMAN AVE APT 41 SHERMAN OAKS, CA 91423 | AFLAC | $37 | $0 | $37 | 0.11% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD. SUITE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $37 | $0 | $37 | 0.11% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD. SANTA ANA, CA 92704 | AFLAC | $35 | $0 | $35 | 0.10% |
| HORACIO J. LANZAS3 Filed as: HORACIO J LANZAS | 7032 BAIRD AVE RESEDA, CA 91335 | AFLAC | $31 | $0 | $31 | 0.09% |
| 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 | $22 | $0 | $22 | 0.06% |
| MARSHALL CHARLES MCDONALD3 | 17031 SUMMERS WALK BLVD. DAVIDSON, NC 28036 | AFLAC | $20 | $0 | $20 | 0.06% |
| GEOFFREY MALAIS3 | PO BOX 280717 NORTHRIDGE, CA 91328 | AFLAC | $17 | $0 | $17 | 0.05% |
| CHRISTOPHER HAGER3 | 44 COLONIAL DR. RANCHO MIRAGE, CA 90045 | AFLAC | $14 | $0 | $14 | 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 | $10 | $0 | $10 | 0.03% |
| DAVID BRYANT3 | 1925 CENTURY PARK E SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $10 | $0 | $10 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST SUITE 615 CHICAGO, IL 60654 | AFLAC | $9 | $0 | $9 | 0.03% |
| KATRINA LAFATA3 | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | AFLAC | $5 | $0 | $5 | 0.01% |
| 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 | $2 | $0 | $2 | 0.01% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 149 MALIBU RD MOORESVILLE, NC 28117 | AFLAC | $2 | $0 | $2 | 0.01% |
| ELIZABETH MICAELA VEGA3 | 11671 STRATHERN STREET NORTH HOLLYWOOD, CA 91605 | AFLAC | $1 | $0 | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $1 | $0 | $1 | 0.00% |
| MEGAN M MILLER3 | 149 MALIBU RD MOORESVILLE, NC 28117 | 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 | 260 | 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) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 309 | $1.4M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 309 | $203K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 309 | $203K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 309 | $203K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 309 | $203K |
| Other | AFLAC | 49 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.