| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | SYMETRA LIFE INSURANCE COMPANY | $27K | $428 | $27K | 6.30% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES LLC | 446 MAIN STREET, 5TH FLOOR WORCESTER, MA 01608 | SYMETRA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 4.68% |
| EBS INSURANCE BROKERS3 Filed as: EBS INSURANCE BROKERS INC | 1 GATEWAY CENTER, SUITE 551 NEWTON, MA 02458 | SYMETRA LIFE INSURANCE COMPANY | $465 | $8K | $8K | 1.95% |
| PAUL ROONEY3 Filed as: PAUL J. ROONEY | 300 WASHINGTON STREET, SUITE 650 NEWTON, CA 02458 | SYMETRA LIFE INSURANCE COMPANY | $30 | $0 | $30 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $14K | $0 | $14K | 3.94% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING INS AGNCY | 1 ADP BOULEVARD MS 625 ROSELAND, NJ 07068 | BLUE CROSS OF CALIFORNIA | $13K | $0 | $13K | 3.74% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SERVICES | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | BLUE CROSS OF CALIFORNIA | — | $12K | $12K | 3.46% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | $0 | $3K | 5.49% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS., INC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | $0 | $1K | 2.49% |
| PAUL ROONEY3 | 1 GATEWAY CENTER, SUITE 650 NEWTON, CA 02458 | KAISER FOUNDATION HEALTH PLAN INC. | -$185 | $0 | -$185 | -0.32% |
| DIXON ASSOCIATES3 | 17 RAILROAD AVENUE DUXBURY, MA 02332 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.26% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $0 | $1K | 5.40% |
| PAUL ROONEY3 Filed as: PAUL J. ROONEY | 1 GATEWAY CENTER, SUITE 650 NEWTON, CA 02458 | UNITEDHEALTHCARE INSURANCE COMPANY | $311 | $0 | $311 | 1.60% |
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 | 416 | 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) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 32 | $428K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 665 | $41K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 416 | $429K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 416 | $429K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 416 | $429K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 32 | $428K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 416 | $429K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 665 | — |
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.