| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $40K | $2K | $42K | 5.73% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $0 | $2K | $2K | 0.30% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 4.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $100 | $100 | 0.13% |
| TIFFANY A TREVINO3 Filed as: TIFFANY A. TREVINO | 6718 BARNHURST DRIVE SAN DIEGO, CA 92117 | AFLAC | $665 | $36 | $701 | 4.41% |
| JACK DANIEL HOLDER3 Filed as: JACK DANIEL HOLDER AND OTHER AGENTS | 3530 CAMINO DEL RIO NORTH SUITE 200 SAN DIEGO, CA 92108 | AFLAC | $295 | $8 | $303 | 1.91% |
| MANUEL ENRIQUE SCHAAR3 Filed as: MANUEL E. SCHAAR | 182 MONTEBELLO STREET CHULA VISTA, CA 91910 | AFLAC | $273 | $0 | $273 | 1.72% |
| KRISTIN BEAN3 | 5058 HAWLEY BOULEVARD SAN DIEGO, CA 92116 | AFLAC | $171 | $0 | $171 | 1.08% |
| LORENA E ROSALES3 Filed as: LORENA E. ROSALES | 4625 POLARIS AVENUE, SUITE 212 LAS VEGAS, NV 89103 | AFLAC | $153 | $0 | $153 | 0.96% |
| WHITNEY L MILLWOOD3 Filed as: WHITNEY L. MILLWOOD | 3654 OGLEBAY DRIVE GREEN COVE SPRINGS, FL 32043 | AFLAC | $106 | $0 | $106 | 0.67% |
| BRANDON M. CROTHERS3 | 1804 MCKEE STREET, UNIT B1 SAN DIEGO, CA 92110 | AFLAC | $66 | $0 | $66 | 0.42% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $803K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $744K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $744K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 116 | $728K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $803K |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $744K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 116 | — |
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.