| 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. | $26K | — | $26K | 4.89% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN, INSURANCE ADMINISTRAT | 721 SOUTH PARKER STREET SUITE 300 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | — | $10K | 1.91% |
| DEMBOSKI & CHAPMAN FINANCIAL3 | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | CALIFORNIA PHYSICIANS' SERVICE | $19K | — | $19K | 5.00% |
| 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 | 1.50% |
| DEMBOSKI & CHAPMAN FINANCIAL3 Filed as: DEMBOSKI CHAPMAN FINANCIAL AND INSU | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | HUMANA INSURANCE COMPANY | $6K | — | $6K | 8.20% |
| CAMERON J BELL3 | 2390 CRENSHAW BOULEVARD SUITE 307 TORRANCE, CA 90501 | AFLAC | $3K | $89 | $3K | 14.77% |
| DEMBOSKI & CHAPMAN FINANCIAL3 | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | AFLAC | $520 | — | $520 | 2.84% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $326 | $21 | $347 | 1.89% |
| GRISWOLD & GRISWOLD INSURANCE3 Filed as: GRISWOLD & GRISWOLD INS AGENCY INC | 2785 PACIFIC COAST HIGHWAY TORRANCE, CA 90505 | AFLAC | $175 | — | $175 | 0.96% |
| TALHA ZAQUIR RAHMAN3 | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $158 | — | $158 | 0.86% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | AFLAC | $56 | — | $56 | 0.31% |
| LEMUEL E FRANKS3 | 2812 GREENFIELD DRIVE EDMOND, OK 73012 | AFLAC | $3 | — | $3 | 0.02% |
| SETH JAFFE3 Filed as: SETH L JAFFE | 4217 EAST MASSACHUSETTS STREET LONG BEACH, CA 90814 | AFLAC | $3 | — | $3 | 0.02% |
| KATHLEEN S HANSON3 | 5460 EAST EL PARQUE STREET LONG BEACH, CA 90815 | AFLAC | $1 | — | $1 | 0.01% |
| DEMBOSKI & CHAPMAN FINANCIAL3 Filed as: DEMBOSKI CHAPMAN FINANCIAL AND INSU | 200 EAST CARRILLO STREET SUITE 203 SANTA BARBARA, CA 93101 | HUMANADENTAL INSURANCE COMPANY | $907 | — | $907 | 5.12% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 88 | $917K |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 93 | $89K |
| Vision | HUMANA INSURANCE COMPANY | 93 | $71K |
| Life insurance | HUMANA INSURANCE COMPANY | 93 | $71K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 36 | $385K |
| Other(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 93 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.