| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $67K | $616 | $68K | 4.64% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $16K | — | $16K | 1.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC | 2393 TOWNSGATE RD STE 101 WESTLAKE VILLAGE, CA 91361 | AFLAC | $441 | — | $441 | 3.87% |
| AMY EVANS3 | 4932 N NORTH MAYWOOD AVE LOS ANGELES, CA 90041 | AFLAC | $202 | — | $202 | 1.77% |
| RENEE SUZANNE CORSO3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $172 | $9 | $181 | 1.59% |
| YOLANDO RICHMAN3 | 10000 NEVADA AVE CHATSWORTH, CA 91311 | AFLAC | $65 | $40 | $105 | 0.92% |
| SHARON S. WIENER3 Filed as: SHARON WIENER | 8833 PICKFORD ST LOS ANGELES, CA 90035 | AFLAC | $90 | — | $90 | 0.79% |
| NASHINA BUSH3 | 7555 DONNA AVE RESEDA, CA 91335 | AFLAC | $79 | — | $79 | 0.69% |
| RICHARD J KUNZ3 Filed as: RICHARD KUNZ | 601 MONTOGMERY ST STE 1475 SAN FRANCISCO, CA 94111 | AFLAC | $53 | — | $53 | 0.47% |
| CHRISTOPHER EVANS3 | 1384 OAKLAND BLVD APT 8 WALNUT CREEK, CA 94596 | AFLAC | $53 | — | $53 | 0.47% |
| ADAM H MICHAELS3 Filed as: ADAM MICHAELS | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $52 | — | $52 | 0.46% |
| BRIAN GEORGE JAEGGI3 | 8591 DYNASTY DR BOCA RATON, FL 33433 | AFLAC | $44 | — | $44 | 0.39% |
| DINORAH ROSSANA DEVALLY3 | 361 MISTY TRAILS PL SIMI VALLEY, CA 93065 | AFLAC | $20 | — | $20 | 0.18% |
| GEOFFREY MALAIS3 | PO BOX 280717 NORTHRIDGE, CA 91328 | AFLAC | $15 | — | $15 | 0.13% |
| CHRISTOPHER HAGER3 | 8021 TRUXTON AVE LOS ANGELES, CA 90045 | AFLAC | $13 | — | $13 | 0.11% |
| LILY YAN3 | 5805 SEPULVEDA BLVD STE 700 SHERMAN OAKS, CA 91411 | AFLAC | $12 | — | $12 | 0.11% |
| LABAN MATTHEW SPALDING3 Filed as: LABAN SPALDING | 29404 QUAIL RUN DR AGOURA HILLS, CA 91301 | AFLAC | $8 | — | $8 | 0.07% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $7 | — | $7 | 0.06% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $6 | — | $6 | 0.05% |
| JOANN SONG ZWAGERMAN3 | 2110 PROSPECT AVE HERMOSA BEACH, CA 90245 | AFLAC | $5 | — | $5 | 0.04% |
| JOSEPH A NASCA3 | 28081 W MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $3 | — | $3 | 0.03% |
| OLENA K SHEA3 | 3 MITCHELL PL UNIT 18C NEW YORK, NY 10017 | AFLAC | $2 | — | $2 | 0.02% |
| BRIAN E KATZ3 | 1032 S SIERRA BONITA AVE LOS ANGELES, CA 90019 | AFLAC | $1 | — | $1 | 0.01% |
| ALFRED RIETKERK3 | 438 PISCAH PIKE PULASKI, TN 38478 | AFLAC | $1 | — | $1 | 0.01% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 173 | $1.5M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 173 | $1.5M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 173 | $1.5M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 173 | $1.5M |
| Short-term disability | AFLAC | 5 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.