| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $100K | $0 | $100K | 5.28% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $8K | $0 | $8K | 2.57% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER, SUITE 250 IRVINE, CA 92618 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $83 | $38K | 16.93% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.88% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER, SUITE 250 IRVINE, CA 92618 | AETNA | $8K | $0 | $8K | 4.97% |
| AMWINS3 Filed as: AMWINS CONNECT INS SRVS, LLC | UNKNOWN CORONA, CA 92883 | AETNA | $5K | $0 | $5K | 2.98% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER, SUITE 250 IRVINE, CA 92618 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $3K | $0 | $3K | 14.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $0 | $350 | $350 | 1.58% |
| CHARINA INIGO3 | 11517 CHADWICK ROAD CORONA, CA 92878 | AFLAC | $500 | $0 | $500 | 13.67% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 5752 WHISTLER CIRCLE HUNTINGTON BEACH, CA 92649 | AFLAC | $88 | $0 | $88 | 2.41% |
| VERONICA RINCON3 | 2018 SOUTH WOODLAND PLACE SANTA ANA, CA 92707 | AFLAC | $33 | $0 | $33 | 0.90% |
| DANIEL TYLER ADAMSON3 Filed as: DANIEL ADAMSON | 405 SOUTH HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $18 | $0 | $18 | 0.49% |
| RONALD B SALMON3 Filed as: RONALD SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $11 | $0 | $11 | 0.30% |
| PEGGY K SALMON3 Filed as: PEGGY SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $2 | $0 | $2 | 0.05% |
| MARK ROBERT MEYER3 Filed as: MARK MEYER AND OTHER AGENTS | 13750 DARVALLE STREET CERRITOS, CA 90703 | AFLAC | $2 | $0 | $2 | 0.05% |
| CHARNINA INIGO3 | 11517 CHADWICK ROAD CORONA, CA 92878 | AFLAC | $788 | $15 | $803 | 25.91% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 5752 WHISTLER CIRCLE HUNTINGTON BEACH, CA 92649 | AFLAC | $133 | $6 | $139 | 4.49% |
| NUBIA REBECA PINA3 Filed as: NUBIA PINA | 8502 WEST WOODCOVE DRIVE, SUITE 210 ANAHEIM, CA 92808 | AFLAC | $82 | $4 | $86 | 2.78% |
| MARK ROBERT MEYER3 Filed as: MARK MEYER AND OTHER AGENTS | 13750 DARVALLE STREET CERRITOS, CA 90703 | AFLAC | $34 | $16 | $50 | 1.61% |
| AURELIO VELA3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $47 | $0 | $47 | 1.52% |
| ANEESA RIVAS3 | 601 DEL NORTE SANTA MARIA, CA 93455 | AFLAC | $42 | $0 | $42 | 1.36% |
| KENNETH G. BARCLAY3 Filed as: KENNETH BARCLAY | 1218 VIA CANDELAS OCEANSIDE, CA 92056 | AFLAC | $24 | $3 | $27 | 0.87% |
| AURELIO VELA3 | 7602 SORENSEN AVENUE WHITTIER, CA 90606 | AFLAC | $100 | $0 | $100 | 6.09% |
| CHARINA INIGO3 | 11517 CHADWICK ROAD CORONA, CA 92878 | AFLAC | $69 | $21 | $90 | 5.48% |
| ANTAWONG THOMPSON3 | 2743 SOUTH SANDPIPER AVENUE ONTARIO, CA 91761 | AFLAC | $14 | $0 | $14 | 0.85% |
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 | 713 | 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) | 713 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 294 | $2.4M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 807 | $244K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 807 | $222K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 807 | $222K |
| Short-term disability(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 807 | $230K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 294 | $2.4M |
| Other(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 807 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 807 | — |
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.