| 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 | $144K | $539 | $144K | 4.98% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA HEALTH OF CALIFORNIA, INC. | $19K | $0 | $19K | 4.94% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $18K | $3K | $21K | 5.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.10% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $495 | $10K | 15.75% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $11 | $5K | 9.56% |
| DAVID A. RACKLIFFE3 | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $23 | $2K | 3.51% |
| JB CREATIVE SOLUTIONS LLC3 Filed as: JB CREATIVE SOLUTIONS, LLC | 3881 FREEMAN WAY PROSPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $298 | $2K | 3.08% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY, III | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $344 | $1K | 2.79% |
| BRIAN YERVANT AKIAN3 | PO BOX 17269 IRVINE, CA 92623 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $985 | $1 | $986 | 1.94% |
| JENNIFER AURORA RAMIREZ3 | 1053 FICUS LANE SAN MARCOS, CA 92069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $324 | $31 | $355 | 0.70% |
| REBECCA J. DEERR3 | 16379 EAST PRESERVE LOOP, UNIT 2004 CHINO, CA 91708 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 22.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 15.81% |
| DAVID SMITH3 Filed as: DAVID MATTHEW SMITH | 5025 NORTH RIMHURST AVENUE COVINA, CA 91724 | CONTINENTAL AMERICAN INSURANCE COMPANY | $623 | $0 | $623 | 8.48% |
| MARIAN ELIZABETH LENCIONI3 | 12859 CRAIG DRIVE RANCHO CUCAMONGA, CA 91739 | CONTINENTAL AMERICAN INSURANCE COMPANY | $456 | $0 | $456 | 6.21% |
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 | 608 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 23 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 633 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 670 | $3.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 670 | $360K |
| Vision | VISION SERVICE PLAN | 347 | $69K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $117K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 45 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $66K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 670 | $3.7M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 670 | — |
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.