| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $124K | — | $124K | 5.18% |
| GEORGIANNA STOUT3 | 150 HARBOUR DR UNIT 370 SAUSALITO, CA 94966 | AFLAC | $613 | $112 | $725 | 1.90% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 Filed as: CREATIVA ASSOCIATES FINACIAL & INS | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | AFLAC | $627 | $1 | $628 | 1.65% |
| AMY EVANS3 | 14358 MAGNOLIA BLVD UNIT 103 SHERMAN OAKS, CA 91423 | AFLAC | $452 | — | $452 | 1.19% |
| MINES INSURANCE SERVICES INC3 | 1519 BARTH AVENUE RICHMOND, CA 94806 | AFLAC | $419 | — | $419 | 1.10% |
| RENEE SUZANNE CORSO3 | 5805 SUPULVEDA BLVD SUITE 740 SHERMAN OAKS, CA 91411 | AFLAC | $340 | $59 | $399 | 1.05% |
| WILLIAM P HOFTO3 | 2910 NEILSON WAY UNIT 410 SANTA MONICA, CA 90405 | AFLAC | $367 | — | $367 | 0.96% |
| RICHARD J KUNZ3 | 351 CALIFORNIA ST SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $217 | $7 | $224 | 0.59% |
| FBRG INSURANCE SERVICES INC.3 Filed as: FBRG INSURANCE SERVICES INC | 1290 S LOS ROBLES PASADENA, CA 91106 | AFLAC | $197 | — | $197 | 0.52% |
| JEAN ANN SCHINDELHEIM3 | 23831 LANESBORO PL VALENCIA, CA 91354 | AFLAC | $191 | — | $191 | 0.50% |
| JULIE ATKINS3 | 165 GRAMERCY DRIVE SAN MATEO, CA 94402 | AFLAC | $162 | $22 | $184 | 0.48% |
| YOLANDA JOY RICHMAN3 Filed as: YOLANDA OY RICHMAN | 10000 NEVADA AVE CHATSWORTH, CA 91311 | AFLAC | $147 | $31 | $178 | 0.47% |
| KANDI M MCINTYRE3 | 2000 MALLORY LANE SUITE 130-378 FRANKLIN, TN 37067 | AFLAC | $155 | — | $155 | 0.41% |
| MARGARET MALLOY3 | 524 EVEN ST NAPA, CA 94559 | AFLAC | $151 | — | $151 | 0.40% |
| JESSICA PLUSKO3 | 1611 MATTHEWS AVE VENTURA, CA 93004 | AFLAC | $143 | — | $143 | 0.38% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST SUITE 220 GRANDA HILLS, CA 91344 | AFLAC | $138 | — | $138 | 0.36% |
| ANNA JANICE RUIZ3 | 351 CALIFORNIA ST SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $86 | $22 | $108 | 0.28% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BLVD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $105 | — | $105 | 0.28% |
| ADAM H MICHAELS3 | 12121 WILSHIRE BLVD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $67 | $15 | $82 | 0.22% |
| ROBERT M. ABIGANA3 Filed as: ROBERT M ABIGANA | 2220 CRESTMOOR DRIVE SAN BRUNO, CA 94066 | AFLAC | $80 | — | $80 | 0.21% |
| LUIS SANCHEZ CARAMBOT3 | P.O. BOX 912 VIEQUES, PR 00765 | AFLAC | $76 | — | $76 | 0.20% |
| JOSHUA BALTOR3 | 11 AIRPORT BLVD SUITE 105 SOUTH SAN FRANCISCO, CA 94080 | AFLAC | $73 | — | $73 | 0.19% |
| STEPHANIE SANDERS3 | 16800 DEVONSHIRE ST SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $67 | — | $67 | 0.18% |
| DAVID SCOTT MANCHESTER3 | 6104 SE HENDERSON STREET PORTLAND, OR 97206 | AFLAC | $60 | — | $60 | 0.16% |
| STEPHANIE L SANDERS3 | 27305 W LIVE OAK RD A437 SANTA CLARITA, CA 91384 | AFLAC | $59 | — | $59 | 0.15% |
| INTEGRATED INSURANCE SERVICES, INC.3 Filed as: INTEGRATED INSURANCE SERVICES INC | P.O. BOX 609 SANTA BARBARA, CA 93102 | AFLAC | $52 | — | $52 | 0.14% |
| BRIAN G JAEGGI3 | 5112 TOPANGA CANYON BLVD WOODLAND HILLS, CA 91364 | AFLAC | $50 | $1 | $51 | 0.13% |
| ALLISON FARRIS WENDELBERGER3 | 1839 YGNACIO VALLEY RD STE 393 WALNUT CREEK, CA 94598 | AFLAC | $29 | $17 | $46 | 0.12% |
| CHRIS BRANSON3 | 351 CALIFORNIA ST STE 450 SAN FRANCISCO, CA 94104 | AFLAC | $43 | — | $43 | 0.11% |
| DANIEL C MERRITT3 | 2435 S SOWELL VISALIA, CA 93277 | AFLAC | $42 | — | $42 | 0.11% |
| ALFRED RIETKERK3 | 3120 NE 47TH ST FT LAUDERDALE, FL 33308 | AFLAC | $40 | — | $40 | 0.11% |
| CALIFORNIA EAST BAY INS SERV INC3 | 5236 TAPESTRY CT FAIRFIELD, CA 94534 | AFLAC | $31 | — | $31 | 0.08% |
| GARY SCOTT NELLIS3 | 10607 1/2 WOODBRIDGE STREET TOLUCA LAKE, CA 91602 | AFLAC | $27 | — | $27 | 0.07% |
| LES HEINSEN INS SERVICES INC3 | 193 BLUE RAVINE RD SUITE 140 FOLSOM, CA 95630 | AFLAC | $26 | — | $26 | 0.07% |
| MARJORIE C ROBINSON3 | 91-1095 KAIKO ST EWA BEACH, HI 96706 | AFLAC | $25 | — | $25 | 0.07% |
| JAMES M GARNER3 Filed as: JAMES GARNER | 1000 FOSTER CITY BLVD APT 6410 FOSTER CITY, CA 94404 | AFLAC | $24 | — | $24 | 0.06% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN DANIEL PAYNE | 110 HASLEMERE CT LAFAYETTE, CA 94549 | AFLAC | $22 | — | $22 | 0.06% |
| EDGEWATER INS SOLUTIONS LLC3 | 1000 FOSTER CITY BLVD APT 6410 FOSTER CITY, CA 94404 | AFLAC | $21 | — | $21 | 0.06% |
| STEPHEN H ARANIO3 | 1136 UNION MALL SUITE 705 HONOLULU, HI 96813 | AFLAC | $20 | — | $20 | 0.05% |
| PATTIE L ARANIO3 | 1136 UNION MALL SUITE 705 HONOLULU, HI 96813 | AFLAC | $19 | — | $19 | 0.05% |
| PIONEER PACIFIC FINANCIAL3 | 1132 BISHOP ST SUITE 2101 HONOLULU, HI 96813 | AFLAC | $18 | — | $18 | 0.05% |
| ROGER M. BERMAN3 Filed as: ROGER M BERMAN | 19500 BALLINGER WAY NE 404 SHORELINE, WA 98155 | AFLAC | $18 | — | $18 | 0.05% |
| MJR INSURANCE SERVICES LLC3 | 7349 PONCE AVENUE WEST HILLS, CA 91307 | AFLAC | $17 | — | $17 | 0.04% |
| COLLEEN ANN DAVIS3 | P.O. BOX 2823 CANYON COUNTRY, CA 91386 | AFLAC | $17 | — | $17 | 0.04% |
| TREVE D RASMUSSEN3 | 3130 W MAIN STREET SUITE E VISALIA, CA 93291 | AFLAC | $17 | — | $17 | 0.04% |
| PETER JAMES SARANTIS3 | 2251 DOUGLAS BLVD SUITE 110 ROSEVILLE, CA 95661 | AFLAC | $13 | — | $13 | 0.03% |
| MICHELLE M PHILLIPS3 | 3130 W MAIN SUITE 2 VISALIA, CA 93291 | AFLAC | $12 | — | $12 | 0.03% |
| WALTER F PETERS3 | 1687 A KALAUOKALANI WAY NUMBER 218 HONOLULU, HI 96814 | AFLAC | $11 | — | $11 | 0.03% |
| MICHELLE MALAIS3 | 31858 CASTAIC RD 314 CASTAIC, CA 91384 | AFLAC | $9 | — | $9 | 0.02% |
| CHRISTIAN FERMAHIN3 | 98 360 KOUAUKA LOOP SUITE 206 AIEA, HI 96701 | AFLAC | $8 | — | $8 | 0.02% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVE SUITE 204 STUDIO CITY, CA 91602 | AFLAC | $8 | — | $8 | 0.02% |
| BENJAMIN R. WERTHIMER3 Filed as: BENJAMIN R WERTHIMER | 6088 DAWN CT ROHNERT PARK, CA 94928 | AFLAC | $8 | — | $8 | 0.02% |
| ANNA JANICE RUIZ3 | 2596 17TH AVE SAN FRANCISCO, CA 94116 | AFLAC | $8 | — | $8 | 0.02% |
| CHRISTOPHER EVANS3 | 14358 MAGNOLIA BLVD APT 103 SHERMAN OAKS, CA 91423 | AFLAC | $7 | — | $7 | 0.02% |
| CHARLES EDWARD PERRY3 | 12858 TORREY PINES DR AUBURN, CA 95602 | AFLAC | $4 | — | $4 | 0.01% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $4 | — | $4 | 0.01% |
| HAWAII PASIFIKA LLC3 | 1100 ALAKEA STREET SUITE 3200 HONOLULU, HI 96813 | AFLAC | $3 | — | $3 | 0.01% |
| GARY LOWE3 | 13106 NANTUCKET PL BAKERSFIELD, CA 93314 | AFLAC | $3 | — | $3 | 0.01% |
| JAMES ARTHUR HARBOUR3 | 1100 ALAKEA STREET STE 3200 HONOLULU, HI 96813 | AFLAC | $2 | — | $2 | 0.01% |
| CREATIVA ASSOCIATES FINANCIAL & INS3 | 28470 AVENUE STANFORD SUITE 300 VALENCIA, CA 91355 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 CLAIM ADMIN DEN | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Contract Administrator Service code 12 | — | $29K |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 220 | $2.5M |
| Dental(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 220 | $2.5M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 220 | $2.4M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 220 | $2.4M |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 225 | $37K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 11 | $78K |
| Other(2 contracts, 2 carriers) | AFLAC | 224 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.