| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 92617 | BLUE SHIELD OF CALIFORNIA | $25 | $63K | $63K | 3.84% |
| FBP INSURANCE SERVICES3 Filed as: FBP INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 92612 | BLUE SHIELD OF CALIFORNIA | $8 | $20K | $20K | 1.21% |
| MCGRIFF INSURANCE SERVICES INC3 | 130 THEORY SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $18K | — | $18K | 3.77% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 3.77% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 4.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $3K | — | $3K | 7.50% |
| JULIE S KRAUS3 | 15066 VARSITY STREET APT. B MOORPARK, CA 93021 | AFLAC | $3K | $202 | $3K | 12.40% |
| AMY SLOKAN3 | 541 W GAINSBOROUGH RD APT 101 THOUSAND OAKS, CA 91360 | AFLAC | $532 | $40 | $572 | 2.22% |
| DEVITA MCKENZIE3 Filed as: DEVITA B MCKENZIE | 300 E ESPLANADE DR STE 1220 OXNARD, CA 93036 | AFLAC | $204 | — | $204 | 0.79% |
| BRADLEY IAN WITT3 | 1621 RIDGEWOOD DR CAMARILLO, CA 93012 | AFLAC | $168 | — | $168 | 0.65% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS INC | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | AFLAC | $114 | $40 | $154 | 0.60% |
| MICHAEL S NOLAN3 | 1445 E LOS ANGELES AVE STE 208 SIMI VALLEY, CA 93065 | AFLAC | $136 | — | $136 | 0.53% |
| MARY LOU GRAHAM3 | 1747 OFELIA WAY OXNARD, CA 93030 | AFLAC | $111 | — | $111 | 0.43% |
| GENA G QUARANTELLO3 | 12962 E VISTAPARK DR MOORPARK, CA 93021 | AFLAC | $43 | — | $43 | 0.17% |
| D BREDESON INSURANCE SERVICES INC3 | 19043 META RD CORNELIUS, NC 28031 | AFLAC | $30 | — | $30 | 0.12% |
| CN BENEFITS INC3 | 4011 SAN LUIS ST NEWBURY PARK, CA 91320 | AFLAC | $28 | — | $28 | 0.11% |
| HANS ERIC ANDERSON2 | 6808 SAINT ESTABAN ST TUJUNGA, CA 91042 | AFLAC | $28 | — | $28 | 0.11% |
| JANET L WEAVER3 | 4090 BLUEBIRD LN OXNARD, CA 93033 | AFLAC | $24 | — | $24 | 0.09% |
| JACQUELINE G LEMSTER3 | 950 ALABAMA ST CANON CITY, CO 81212 | AFLAC | $20 | — | $20 | 0.08% |
| MARSHALL CHARLES MCDONALD3 | 17031 SUMMERS WALK BLVD DAVIDSON, NC 28036 | AFLAC | $15 | — | $15 | 0.06% |
| GENA GRACE QUARANTELLO3 | 12962 E VISTAPARK DR MOORPARK, CA 93021 | AFLAC | $13 | — | $13 | 0.05% |
| RICHARD J KUNZ3 | 601 MONTGOMERY ST STE 1475 SAN FRANCISCO, CA 94111 | AFLAC | $13 | — | $13 | 0.05% |
| JOSEPH RAY HARDIE3 | 909 E PLAYA DEL NORTE DR APT 6011 TEMPE, AZ 85281 | AFLAC | $12 | — | $12 | 0.05% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $10 | — | $10 | 0.04% |
| SCOTT W BLACKSHEAR3 | 181 OLETA WAY ST AUGUSTINE, FL 32095 | AFLAC | $10 | — | $10 | 0.04% |
| MARGARET M CUTLER3 | PO BOX 1042 MOORPARK, CA 93020 | AFLAC | $8 | — | $8 | 0.03% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 641 HIGUERA ST STE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $8 | — | $8 | 0.03% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $6 | — | $6 | 0.02% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $6 | — | $6 | 0.02% |
| SHANE M OWEN3 Filed as: SHANE CRAIG DAVISON | 3013 LARGE HOP LN ANTIOCH, TN 37013 | AFLAC | $6 | — | $6 | 0.02% |
| CHARLES D. BLOCK3 Filed as: CHARLES B CAREY | 16215 LYLE ST SAN LEANDRO, CA 94578 | AFLAC | $4 | — | $4 | 0.02% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 9300 HARRIS CORNERS PKWY STE 100 CHARLOTTE, NC 28269 | AFLAC | $3 | — | $3 | 0.01% |
| DOUGLAS E FOX3 | 6836 THAYER LAKE DR ALDEN, MI 49612 | AFLAC | $3 | — | $3 | 0.01% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER LYMAN SR | 8 S VOLUNTARIO ST UNIT A SANTA BARBARA, CA 93103 | AFLAC | $2 | — | $2 | 0.01% |
| DOUGLAS MARTIN BELSER3 | 26211 INDIANA BLVD NOVI, MI 48374 | AFLAC | $1 | — | $1 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH H WILLIS JR | 1431 NE 55TH ST FORT LAUDERDALE, FL 33334 | AFLAC | $1 | — | $1 | 0.00% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $1 | — | $1 | 0.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 7.50% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY, SUITE 200 IRVINE, CA 92617 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $389 | — | $389 | 2.49% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $205 | — | $205 | 7.33% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY, STE 200 IRVINE, CA 92617 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $75 | — | $75 | 2.68% |
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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 188 | $2.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 352 | $236K |
| Vision | VISION SERVICE PLAN | 148 | $34K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 148 | $48K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 148 | $25K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 148 | $25K |
| Prescription drug(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 188 | $2.5M |
| Other(5 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 149 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 352 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.