| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARPENTER, MARK J3 Filed as: CARPENTER, MARK | 306 6TH AVENUE, SUITE C SAN MATEO, CA 94401 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | $186K | — | $186K | 3.53% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND | FINANCIAL SERVICES 12404 PARK CENTRAL DR SUITE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | — | $118K | $118K | 2.23% |
| MARK CARPENTER3 | 306 SIXTH AVE. SUITE C SAN MATEO, CA 94401 | ANTHEM LIFE INSURANCE COMPANY | $5K | — | $5K | 8.01% |
| MARK CARPENTER3 | 306 SIXTH AVE. SUITE C SAN MATEO, CA 94401 | ANTHEM LIFE INSURANCE COMPANY | $5K | — | $5K | 8.02% |
| MARK CARPENTER3 | 306 SIXTH AVE. SUITE C SAN MATEO, CA 94401 | ANTHEM LIFE INSURANCE COMPANY | $5K | — | $5K | 8.01% |
| SHAWNA PABST3 | 1303 E LEVEE DR MOHAVE VALLEY, AZ 86440 | AFLAC | $47 | — | $47 | 5.05% |
| ELIZABETH ANNE BACON3 | 29411 SW CAMELOT ST WILSONVILLE, OR 97070 | AFLAC | $26 | — | $26 | 2.79% |
| WILLIAM JAMES MCPHEE3 | 20332 SW ERIN PL ALOHA, OR 97003 | AFLAC | $23 | — | $23 | 2.47% |
| JERRY OLIVER CREECH3 | 5915 SANTO DOMINGO CT NEW BERN, NC 28560 | AFLAC | $10 | — | $10 | 1.07% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $7 | — | $7 | 0.75% |
| ERIC DANIEL WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $1 | — | $1 | 0.11% |
| GINA SIENIA3 | PO BOX 446 ECHO, OR 97826 | AFLAC | $1 | — | $1 | 0.11% |
| JANELLE MARIE GADOMSKI3 | 48 FAIRVIEW AVE PARK RIDGE, NJ 07656 | AFLAC | $9 | — | $9 | 4.13% |
| JOSHUA BALTOR3 Filed as: JOSHUA STEVEN BALTOR | 533 AIRPORT BLVD STE 400 BURLINGAME, CA 94010 | AFLAC | $6 | — | $6 | 2.75% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY D HARDIE | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $4 | — | $4 | 1.83% |
| TREVOR FENNELL3 Filed as: TREVOR R FENNELL | 7 HIGHLAND LN EAST HAMPTON, NY 11937 | AFLAC | $2 | — | $2 | 0.92% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $1 | — | $1 | 0.46% |
| CHRISTY M DAY3 | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $1 | — | $1 | 0.46% |
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 | 335 | 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) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 469 | $5.3M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 469 | $5.3M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 469 | $5.3M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 343 | $64K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 343 | $70K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 343 | $59K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 469 | $5.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 469 | — |
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.
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.