| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 3.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $14K | — | $14K | 9.93% |
| BRIAN ROBERT LLOYD3 | PO BOX 11 KNIGHTSEN, CA 94548 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $6K | $9K | 13.10% |
| MJ INSURANCE3 Filed as: WAYNE P. SMITH AND VARIOUS AGENTS | 1113 WEST GROVE WAY COUER DALENE, ID 83815 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $558 | $5K | 7.16% |
| CASEY JAMES KUGLER3 | 336 PACIFICA DRIVE BRENTWOOD, CA 94513 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $582 | $2K | $3K | 4.05% |
| STEPHANIE NOELLE KUGLER3 Filed as: STEPHANIE NOELLE JEFFRIES | 336 PACIFICA DRIVE BRENTWOOD, CA 94513 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $925 | $3K | 3.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3247 WEST MARCH LANE STOCKTON, CA 95219 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.58% |
| MARY KOCH3 | 1012 EMMA ROSE BOULEVARD BRENTWOOD, CA 94513 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $610 | $2K | 2.58% |
| PAMELA KAY LONG3 | 200 SOUTH LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $95 | $2K | 2.39% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | 2122 KRATKY ROAD SAINT LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $422 | $6K | 11.14% |
| TSM INSURANCE & FINANCIAL SERVICES3 Filed as: TSM INSURANCE AND FINANCIAL SVCS. | 1317 OAKDALE ROAD, SUITE 910 MODESTO, CA 95355 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.30% |
| TSM INSURANCE & FINANCIAL SERVICES3 Filed as: TSM INSURANCE AND FINANCIAL SVCS. | 1317 OAKDALE ROAD, SUITE 910 MODESTO, CA 95355 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 11.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 7369 STOCKTON, CA 95267 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $6K | — | $6K | 28.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $817 | — | $817 | 4.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2021 WEST MARCH LANE, 3RD FLOOR STOCKTON, CA 95207 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $104 | $1K | 11.01% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 80 | $517K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 203 | $140K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 346 | $19K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 217 | $76K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 206 | $97K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 206 | $32K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 80 | $452K |
| Other(4 contracts, 4 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 252 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 346 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.