| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 6100 FAIRVIEW ROAD STE 1400, 14TH FLOOR CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | — | $51K | $51K | 0.17% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 921235380 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $22K | $22K | 2.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $89 | $5K | 0.65% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $608 | $608 | 0.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1 | $1 | 0.00% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 921235380 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $2K | $18K | 22.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $89 | $5K | 6.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $367 | $367 | 0.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.00% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 921235380 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $2K | $14K | 19.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRIGINA BEACH, VA 234662939 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $89 | $4K | 5.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRIGINA BEACH, VA 234662939 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $385 | $385 | 0.52% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRIGINA BEACH, VA 234662939 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.00% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 921235380 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $2K | $14K | 19.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRIGINA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $89 | $4K | 5.81% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRIGINA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $321 | $321 | 0.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRIGINA BEACH, VA 234666119 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS EIN 38-2384171 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $539K |
| SEAN COOLEY EIN 31-6654730 EMPLOYEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $288K |
| USI NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 21250 HAWTHORNE BLVD SUITE 380 TORRANCE, CA 90250 | $250K |
| BDO EIN 13-5381590 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $225K |
| TAYLOR AND TAYLOR ASSOCIATES, INC NONE | Direct payment from the plan; Insurance services; Consulting (general) Service code 16 | 271 MADISON AVENUE 5TH FLOOR NEW YORK, NY 10016 | $90K |
| MATTHEW S MILLER EIN 31-6654730 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| MILL CREEK CAPITAL ADVISORS, LLC EIN 41-2212501 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $77K |
| MARYANN SANTAMARIA EIN 31-6654730 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $44K |
| ELLENOFF GROSSMAN & SCHOLE LLP EIN 13-3643185 NONE | Legal; Direct payment from the plan Service code 29 | — | $21K |
| AGINCOURT CAPITAL MANAGEMENT, LLC EIN 54-1947440 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $12K |
| ANDREW COLON EIN 31-6654730 TRUSTEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $11K |
| APERIO GROUP, LLC EIN 68-0436509 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $11K |
| US BANK EIN 41-0255900 NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $10K |
| SMART SOURCE LLC EIN 05-4210434 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $9K |
| THE WAGNER LAW GROUP EIN 94-0922040 NONE | Legal; Direct payment from the plan Service code 29 | — | $7K |
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 | 3,304 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 3,304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 2,906 | $31.1M |
| Dental | BLUE CROSS OF CALIFORNIA | 2,906 | $30.9M |
| Vision | BLUE CROSS OF CALIFORNIA | 2,906 | $30.9M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,179 | $749K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,179 | $749K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,179 | $749K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 2,179 | $749K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,906 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.