| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEMBOSKI & CHAPMAN FINANCIAL3 Filed as: DEMBOSKI & CHAPMAN FINANCIAL AND IN | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | KAISER FOUNDATION HEALTH PLAN, INC. | $33K | — | $33K | 4.86% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMINISTRATO | 721 SOUTH PARKER STREET SUITE 300 ORANGE, CO 92868 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 1.77% |
| DEMBOSKI & CHAPMAN FINANCIAL3 | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | CALIFORNIA PHYSICIANS' SERVICE | $20K | — | $20K | 4.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMINISTRAT | 701 SOUTH PARKER STREET 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | $6K | — | $6K | 1.39% |
| DEMBOSKI & CHAPMAN FINANCIAL3 Filed as: DEMBOSKI CHAPMAN FINANCIAL AND INSU | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | HUMANA INSURANCE COMPANY | $7K | — | $7K | 7.96% |
| CAMERON J BELL3 | 2390 CRENSHAW BOULEVARD SUITE 307 TORRANCE, CA 90501 | AFLAC | $2K | $139 | $3K | 12.71% |
| DEMBOSKI & CHAPMAN FINANCIAL3 | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | AFLAC | $566 | — | $566 | 2.75% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $315 | $27 | $342 | 1.66% |
| GRISWOLD & GRISWOLD INSURANCE3 Filed as: GRISWOLD & GRISWOLD INS AGENCY INC | 2785 PACIFIC COAST HIGHWAY TORRANCE, CA 90505 | AFLAC | $173 | — | $173 | 0.84% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $156 | — | $156 | 0.76% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | AFLAC | $43 | — | $43 | 0.21% |
| BRANDON TYLOR-DA SHIRLEY3 | 5110 SOUTH SHERBOURNE DRIVE LOS ANGELES, CA 90056 | AFLAC | $6 | — | $6 | 0.03% |
| DEMBOSKI & CHAPMAN FINANCIAL3 Filed as: DEMBOSKI CHAPMAN FINANCIAL AND INSU | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | HUMANADENTAL INSURANCE COMPANY | $669 | — | $669 | 4.94% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 120 | $1.1M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 109 | $96K |
| Vision | HUMANA INSURANCE COMPANY | 109 | $82K |
| Life insurance | HUMANA INSURANCE COMPANY | 109 | $82K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 43 | $439K |
| Other(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 109 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.