| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SERVICES | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $69K | — | $69K | 4.82% |
| MJ INSURANCE3 Filed as: JOHN J. MACIAS AND VARIOUS AGENTS | 950 NORTH UNIVERSITY PARK LOOP RENO, NV 89512 | AFLAC | $4K | $26 | $4K | 6.44% |
| CATHERINE ESTES3 Filed as: CATHERINE S. ESTES | 785 TUCKER ROAD, SUITE G233 TEHACHAPI, CA 93561 | AFLAC | $2K | $69 | $2K | 3.69% |
| DAVID W. LANKIN3 | 5244 CANGAS DRIVE AGOURA HILLS, CA 91301 | AFLAC | $2K | $59 | $2K | 2.92% |
| PAULINE M. SIMPSON3 | 2726 TAMARISK AVENUE STOCKTON, CA 95207 | AFLAC | $695 | — | $695 | 1.22% |
| ROCHELLE R MAURER3 Filed as: ROCHELLE R. MAURER | 43535 17TH STREET WEST, SUITE 501 LANCASTER, CA 93534 | AFLAC | $585 | $26 | $611 | 1.08% |
| ROXANNE WISWOSSER3 | 43535 17TH STREET WEST, SUITE 501 LANCASTER, CA 93534 | AFLAC | $540 | $14 | $554 | 0.98% |
| SANDER A. KESSLER AND ASSOCIATES3 | 2850 OCEAN PARK BOULEVARD SUITE 200 SANTA MONICA, CA 90405 | AFLAC | $501 | — | $501 | 0.88% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SERVICES | 2211 MICHELSON DRIVE IRVINE, CA 92612 | EYEMED VISION CARE | $2K | — | $2K | 10.79% |
| CATHERINE ESTES3 Filed as: CATHERINE S. ESTES | 20437 BRIAN WAY, SUITE E TEHACHAPI, CA 93561 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 11.10% |
| ROCHELLE MAURER3 Filed as: ROCHELLE R. GONZALEZ | 110 SUTTER STREET, APT. 25 TECHACHAPI, CA 93561 | CONTINENTAL AMERICAN INSURANCE COMPANY | $217 | — | $217 | 2.24% |
| DAVID W. LANKIN3 | 22350 BRIARWOOD STREET TEHACHAPI, CA 93561 | CONTINENTAL AMERICAN INSURANCE COMPANY | $211 | — | $211 | 2.17% |
| ROXANNE K. WISWOSSER3 | 44942 CEDAR AVENUE, APT. 122 LANCASTER, CA 93534 | CONTINENTAL AMERICAN INSURANCE COMPANY | $208 | — | $208 | 2.14% |
| MJ INSURANCE3 Filed as: TRULY B. PENEDA AND VARIOUS AGENTS | 3665 MOUNT ACADIA BOULEVARD SAN DIEGO, CA 92111 | CONTINENTAL AMERICAN INSURANCE COMPANY | $141 | — | $141 | 1.45% |
| D BREDESON INSURANCE SERVICES INC3 Filed as: D. BREDESON INSURANCE SERVICES, INC | 541 HIGUERA STREET, SUITE 300 SAN LUIS OBISPO, CA 93401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $48 | — | $48 | 0.49% |
| PAULINE M. SIMPSON3 | 3546 BEN LANE STOCKTON, CA 95206 | CONTINENTAL AMERICAN INSURANCE COMPANY | $41 | — | $41 | 0.42% |
| JOHN PACHECO4 | 3436 EAST SYCAMORE AVENUE VISALIA, CA 93292 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $185 | — | $185 | 3.22% |
| LISA N PEART4 Filed as: LISA N. PEART | 1426 WEST 121ST STREET LOS ANGELES, CA 90047 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $156 | — | $156 | 2.72% |
| INTEGRITY ASSET SERVICES LLC4 | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $88 | — | $88 | 1.53% |
| ANGEL L. STEPHENS4 | PO BOX 36114 LOS ANGELES, CA 90036 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $52 | — | $52 | 0.91% |
| NICOLE BUTKOVICH4 | 199 MIRIAM WAY CARSON CITY, NV 89706 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $35 | — | $35 | 0.61% |
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 | 346 | 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) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 342 | $1.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 342 | $1.4M |
| Vision | EYEMED VISION CARE | 314 | $20K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 342 | $1.4M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 342 | $1.4M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 342 | $1.4M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 342 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.