| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $119K | $0 | $119K | 10.90% |
| BSC AGENCY LLC3 Filed as: BSC AGENCY | 1025 ASHWORTH ROAD, SUITE 101 WEST DES MOINES, IA 50265 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $7K | $7K | 0.60% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 140 2ND STREET PETALUMA, CA 94952 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 0.58% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 140 2ND STREET PETLUMA, CA 94952 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $584 | $0 | $584 | 0.05% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INSURANCE COMPANY MEDICARE SUPPLEMENT | $25K | $0 | $25K | 12.51% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | UNITED AMERICAN INSURANCE COMPANY MEDICARE SUPPLEMENT | $7K | $0 | $7K | 3.48% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS, INC. | $8K | $0 | $8K | 6.58% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | EXPRESS SCRIPTS, INC. | $3K | $0 | $3K | 2.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.58% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | VISION SERVICE PLAN | -$109 | $0 | -$109 | -0.09% |
| MICHAEL CRAFORD3 Filed as: MICHAEL DAVID CRAFORD | 990 5TH AVENUE SAN RAFAEL, CA 94901 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $0 | $18K | 22.03% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 990 5TH AVENUE SAN RAFAEL, CA 94901 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 2.87% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST, INC. | 165 BROADWAY, SUITE 3201 1 LIBERTY PLAZA NEW YORK, NY 10006 | ZURICH AMERICAN INSURANCE COMPANY | $8K | $0 | $8K | 20.00% |
| MICHAEL CRAFORD3 Filed as: MICHAEL DAVID CRAFORD | 990 5TH AVENUE SAN RAFAEL, CA 94901 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $918 | $0 | $918 | 22.38% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 990 5TH AVENUE SAN RAFAEL, CA 94901 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $144 | $144 | 3.51% |
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 | 390 | 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) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED AMERICAN INSURANCE COMPANY MEDICARE SUPPLEMENT | 75 | $200K |
| Vision | VISION SERVICE PLAN | 917 | $122K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 390 | $1.1M |
| Short-term disability(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 390 | $1.2M |
| Long-term disability(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 390 | $1.2M |
| Prescription drug | EXPRESS SCRIPTS, INC. | 75 | $126K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 390 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 917 | — |
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.