| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | CALIFORNIA PHYSICIANS SERVICE | $45K | $0 | $45K | 5.74% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 3.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 1.89% |
| TSM INSURANCE & FINANCIAL SERVICES3 Filed as: TSM INS. AND FINANCIAL SERVICES | 1317 OAKDALE ROAD, SUITE 910 MODESTO, CA 95355 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.02% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | 2122 KRATKY ROAD SAINT LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $279 | $3K | 7.56% |
| CASEY JAMES KUGLER3 Filed as: CASEY J. KUGLER AND OTHER AGENTS | 336 PACIFICA DRIVE BRENTWOOD, CA 94513 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $540 | $2K | 4.35% |
| BRIAN ROBERT LLOYD3 Filed as: BRIAN ROBER LLOYD | PO BOX 11 KNIGHTSEN, CA 94548 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $422 | $331 | $753 | 1.65% |
| ANDREA LOUISE WILLIAMSON3 | 5375 LAKESPRING DRIVE OAKLEY, CA 94561 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $522 | $220 | $742 | 1.62% |
| BRITTANY LLOYD3 | 309 PARKFIELD WAY OAKLEY, CA 94561 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $340 | $398 | $738 | 1.61% |
| WAYNE RIMMER3 Filed as: WAYNE P. SMITH | 1113 WEST GROVE WAY COEUR D ALENE, ID 83815 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $637 | $0 | $637 | 1.39% |
| STEPHANIE NOELLE KUGLER3 | 336 PACIFICA DRIVE BRENTWOOD, CA 94513 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $396 | $120 | $516 | 1.13% |
| TSM INSURANCE & FINANCIAL SERVICES3 Filed as: TSM INS. AND FINANCIAL SERVICES | 1317 OAKDALE ROAD, SUITE 910 MODESTO, CA 95355 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 9.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $155 | $0 | $155 | 0.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $928 | $0 | $928 | 10.01% |
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 | 196 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 121 | $1.5M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 102 | $791K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 321 | $17K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 199 | $85K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $30K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 121 | $1.5M |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 283 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.