| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK CHARLES ROSENTHAL3 | 11813 IOWA AVENUE #2 LOS ANGELES, CA 90025 | HEALTH NET | $39K | — | $39K | 2.74% |
| GORDON THOMAS COLBURN3 | 981 W ARROW HIGHWAY 367 SAN DIMAS, CA 91773 | HEALTH NET | $2K | — | $2K | 0.16% |
| MICHELLE DERAS3 | 5805 SEPULVEDA BOULEVARD SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $8K | $488 | $9K | 10.31% |
| MARK CHARLES ROSENTHAL3 Filed as: MARK ROSENTHAL | 11813 IOWA AVENUE #2 LOAS ANGELES, CA 90025 | AFLAC | $3K | — | $3K | 3.66% |
| SVETLANA MAGILNER3 | 5885 SEPULVEDA BOULEVARD SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $2K | $35 | $2K | 2.19% |
| KRISTINA J KUNZ3 Filed as: KRISTINA KUNZ | 351 CALIFORNIA STREET SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $2K | — | $2K | 1.85% |
| BRIAN GEORGE JAEGGI3 Filed as: BRIAN JAEGGI | 5700 CHICOPEE AVENUE ENCINO, CA 91316 | AFLAC | $1K | $98 | $1K | 1.67% |
| RICHARD J KUNZ3 Filed as: RICHARD KUNZ | 351 CALIFORNIA STREET SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $649 | — | $649 | 0.76% |
| RYAN KARRER3 | 11800 GOSHEN AVENUE APT 206 LOS ANGELES, CA 90049 | AFLAC | $388 | $63 | $451 | 0.53% |
| ADAM H MICHAELS3 Filed as: ADAM MICHAELS | 12121 WILSHIRE BOULEVARD SUITW 1225 LOS ANGELES, CA 90025 | AFLAC | $433 | — | $433 | 0.51% |
| RENEE SUZANNE CORSO3 Filed as: RENEE CORSO | 5805 SEPULVEDA BOULEVARD SUITE 700, SUITE 740 SHERMAN OAKS, CA 91411 | AFLAC | $273 | — | $273 | 0.32% |
| PAUL GALLEGOS3 | 10519 HOSHONE AVENUE GRANDA HILLS, CA 91344 | AFLAC | $272 | — | $272 | 0.32% |
| CARIE ROLLS3 | 10632 DEBRA AVENUE GRANADA HILLS, CA 91344 | AFLAC | $270 | — | $270 | 0.32% |
| JOHN KUNZ3 | 5805 SEPULVEDA BOULEVARD SUITE 740 SHERMAN OAKS, CA 91411 | AFLAC | $258 | — | $258 | 0.30% |
| RAQUEL RAMIREZ3 | 1542 WASHINGTON STREET HOLLYWOOD, FL 33020 | AFLAC | $137 | — | $137 | 0.16% |
| CINDY R EICHOLTZ3 Filed as: CINDY EICHOLTZ | 321 BROADACRE ROAD NE DALTON, GA 30721 | AFLAC | $78 | — | $78 | 0.09% |
| MATTHEW RICHARDS DICKSON3 Filed as: MATTHEW DICKSON | 1356 ANNAPOLIS WAY GRAYSON, GA 30017 | AFLAC | $35 | — | $35 | 0.04% |
| HAHHAN MILLER BEAUCHAMP DEEBLE INC3 | 3633 E BROADWAY SUITE 200 LONG BEACH, CA 90803 | AFLAC | $30 | — | $30 | 0.04% |
| JORDAN A KEOGH3 Filed as: JORDAN KEOGH | 28763 BRISTOL STREET HIGHLAND, CA 92346 | AFLAC | $21 | $7 | $28 | 0.03% |
| JUDY M BIRD3 Filed as: JUDY BIRD | 1905 RICHLAND LANE DALTON, GA 30720 | AFLAC | $15 | — | $15 | 0.02% |
| COLLEEN M KIRKLAND3 Filed as: COLLEEN LAWS | 1932 E DEERE AVENUE SUITE 240 SANTA ANA, CA 92705 | AFLAC | $11 | $3 | $14 | 0.02% |
| KATTY W COHEN3 Filed as: KATTY COHEN | 21711 TOWN PLACE DRIVE BOCA RATON, FL 33433 | AFLAC | $12 | — | $12 | 0.01% |
| ANNETTE BURNS3 | 27125 SIERRA HIGHWAY APT 308 SANTA CLARITA, CA 91351 | AFLAC | $9 | — | $9 | 0.01% |
| CORKY SOCORRO EMETT3 Filed as: CORKY EMETT | 80579 APPLE COURT INDIO, CA 92201 | AFLAC | $8 | — | $8 | 0.01% |
| G SCOTT COOKE3 | 2832 NE 17TH AVENUE WILTON MANORS, FL 33354 | AFLAC | $6 | $2 | $8 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL STACHOWIAK | 12121 WILSHIRE BOULEVARD LOS ANGELES, CA 90025 | AFLAC | $3 | $5 | $8 | 0.01% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DRIVE LOS ANGELES, CA 90045 | AFLAC | $7 | — | $7 | 0.01% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH BUZZELLO | 9018 BALBO BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $7 | — | $7 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BOULEVARD 6TH FL GLENDALE, CA 91203 | AFLAC | $6 | — | $6 | 0.01% |
| MICHAEL R. FISHER3 Filed as: MICHAEL FISHER | 3201 WILSHIRE BOULEVARD SUITE 102 SANTA MONICA, CA 90403 | AFLAC | $1 | $5 | $6 | 0.01% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE STREET SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $4 | — | $4 | 0.00% |
| RONALD S SANDERS3 Filed as: RONALD SANDERS | 1194 C LAKEVIEW DRT SAN TAN VALLEY, AZ 85143 | AFLAC | $2 | — | $2 | 0.00% |
| HAROLD L STAFFORD3 Filed as: HAROLD STAFFORD | 15655 77TH TRL N PALM BEACH GARDENS, FL 33418 | AFLAC | $2 | — | $2 | 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 | 366 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 366 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 361 | $1.5M |
| Dental | HEALTH NET | 361 | $1.4M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 97 | $6K |
| Other | AFLAC | 155 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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."
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.