| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| E LEE & ASSOCIATES INC.3 Filed as: E LEE & ASSOCIATES INC | 16835 W BERNARDO DR, #212 SAN DIEGO, CA 92127 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $111K | — | $111K | 6.37% |
| BETTY MURDOCK3 | 2980 FLORINE AVE RIVERSIDE, CA 92509 | AFLAC | $3K | $28 | $3K | 8.61% |
| ACEVES INSURANCE SERVICES INC.3 Filed as: ACEVES INSURANCE SERVICES INC | 9959 BROOKSHIRE AVE DOWNEY, CA 90240 | AFLAC | $371 | — | $371 | 1.15% |
| KATHLEEN S HANSON3 | 2581 HILLCREST ST SIGNAL HILL, CA 90755 | AFLAC | $287 | — | $287 | 0.89% |
| ANDREA M MACIAS3 | 2980 FLORINE AVE RIVERSIDE, CA 92509 | AFLAC | $256 | — | $256 | 0.79% |
| JUANITA BURKS & ASSOCIATES3 | 6100 CENTER DR STE 670 LOS ANGELES, CA 90045 | AFLAC | $229 | $9 | $238 | 0.73% |
| KENNETH J WOOD3 | 10224 MANORVILLE DR JACKSONVILLE, FL 32221 | AFLAC | $208 | — | $208 | 0.64% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DR LOS ANGELES, CA 90045 | AFLAC | $167 | $6 | $173 | 0.53% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $137 | — | $137 | 0.42% |
| RENE CASTRO3 | 2581 HILLCREST ST SIGNAL HILL, CA 90755 | AFLAC | $136 | — | $136 | 0.42% |
| CHRIS GUZEWICH3 | 1007 DRAKE FEATHER DR ORANGE PARK, FL 32065 | AFLAC | $85 | — | $85 | 0.26% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $53 | — | $53 | 0.16% |
| THELMA ZAMBRANO3 Filed as: THELMA ALICIA SOLIS | 8504 FIRESTONE BLVD 276 DOWNEY, CA 90241 | AFLAC | $42 | $9 | $51 | 0.16% |
| TIANI C. WARREN3 Filed as: TIANI C WARREN | 5700 COLISEUM ST LOS ANGELES, CA 90016 | AFLAC | $42 | $9 | $51 | 0.16% |
| H HOWARD THOMSON3 | 65 PINE AVE 102 LONG BEACH, CA 90802 | AFLAC | $46 | — | $46 | 0.14% |
| THOMAS JAMES OLLER3 | 2010 COPPER CREEK DR UNIT C FLEMING ISLAND, FL 32003 | AFLAC | $45 | — | $45 | 0.14% |
| KAREN M HUGHES3 | 3120 NE 47TH ST FORT LAUDERDALE, FL 33308 | AFLAC | $40 | — | $40 | 0.12% |
| FRAN C HARGARTEN III3 | 1140 MOSSY ROCK RD NW KENNESAW, GA 30152 | AFLAC | $32 | — | $32 | 0.10% |
| TROY DANIEL DESLATTE3 | 107 SHADY PARK DR LAFAYETTE, LA 70508 | AFLAC | $30 | — | $30 | 0.09% |
| DARRYL W VIDOR3 | 104 PIONEER DRIVE FOLSOM, CA 95630 | AFLAC | $28 | — | $28 | 0.09% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE ST STE 220 GRANADA HILLS, CA 91344 | AFLAC | $21 | $4 | $25 | 0.08% |
| MOISES VILLALOBOS3 | 6122 WOODLAWN AVE MAYWOOD, CA 90270 | AFLAC | $17 | — | $17 | 0.05% |
| ADAM H MICHAELS3 | 12121 WILSHIRE BLVD STE 1225 LOS ANGELES, CA 90025 | AFLAC | $13 | $4 | $17 | 0.05% |
| JAY S WILLIAMS3 | 3464 HATHAWAY AVE APT 335 LONG BEACH, CA 90815 | AFLAC | $8 | — | $8 | 0.02% |
| APRIL MARIE ROBERTS3 | 62 N MARKET ST STE 310 WAILUKU, HI 96793 | AFLAC | $6 | — | $6 | 0.02% |
| BRANDON C ADAMS3 | 321 SOUTHLAKE DR SAINT AUGUSTINE, FL 32092 | AFLAC | $6 | — | $6 | 0.02% |
| J C ADAMS INC3 | 5631 NE 31ST TER OCALA, FL 34479 | AFLAC | $5 | — | $5 | 0.02% |
| ALFRED RIETKERK3 Filed as: ALFRED RIETERK | 3120 NE 47TH ST FT LAUDERDALE, FL 33308 | AFLAC | $4 | — | $4 | 0.01% |
| LES HEINSEN INS SERVICES INC3 | 193 BLUE RAVINE RD STE 140 FOLSOM, CA 95630 | AFLAC | $3 | — | $3 | 0.01% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 358 | $1.7M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 358 | $1.7M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 358 | $1.7M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 358 | $1.7M |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 358 | $1.7M |
| Other | AFLAC | 36 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.
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.