| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $18K | $0 | $18K | 1.86% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 0.83% |
| USI INSURANCE SERVICES LLC3 | 2800 WEST MARCH LAND, SUITE 100 STOCKTON, CA 95219 | SUTTER HEALTH PLAN | $42K | $0 | $42K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $21K | $0 | $21K | 10.00% |
| 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 | 10.01% |
| STRATEGIC NON-MEDICAL SOLUTION3 | ONE BEACON STREET, SUITE 17100 BOSTON, MA 02108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $10 | $1K | 3.41% |
| BRITTANY LLOYD3 | 6234 KINGS PEAK DRIVE EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $441 | $144 | $585 | 1.69% |
| STEPHANIE NOELLE KUGLER3 Filed as: STEPHANIE N. KUGLER & OTHER AGENTS | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $513 | $43 | $556 | 1.61% |
| WAYNE RIMMER3 Filed as: WAYNE P. SMITH | 402 WEST LOCKHART LANE MERIDIAN, ID 83646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $326 | $0 | $326 | 0.94% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $211 | $94 | $305 | 0.88% |
| BRIAN ROBERT LLOYD3 | 5187 BRENTFORD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $111 | $301 | 0.87% |
| CASEY JAMES KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $118 | $152 | $270 | 0.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.07% |
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 | 162 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 142 | $1.8M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 226 | $209K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 317 | $23K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 226 | $244K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 226 | $244K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 142 | $1.8M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 226 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.