| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA HEALTH OF CALIFORNIA INC. | $118K | $11K | $129K | 4.46% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 4.09% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $3K | $24K | 9.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4 | $4 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 2000 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $62 | $5K | 10.44% |
| JB CREATIVE SOLUTIONS LLC3 Filed as: JB CREATIVE SOLUTIONS, LLC | 3881 FREEMAN WAY PROSPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $30 | $2K | 4.76% |
| DAVID A. RACKLIFFE3 | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.38% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $869 | $193 | $1K | 2.37% |
| JENNIFER AURORA RAMIREZ3 | 4120 WHITTIER STREET SAN DIEGO, CA 92107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $89 | $0 | $89 | 0.20% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $3K | $363 | $3K | 9.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $217 | $0 | $217 | 1.90% |
| DAVID SMITH3 Filed as: DAVID MATTHEW SMITH | 5025 NORTH RIMHURST AVENUE COVINA, CA 91724 | CONTINENTAL AMERICAN INSURANCE COMPANY | $157 | $0 | $157 | 1.37% |
| MARIAN ELIZABETH LENCIONI3 Filed as: MARIAN ELIZABETH BURNS | 12859 CRAIG DRIVE RANCHO CUCAMONGA, CA 91739 | CONTINENTAL AMERICAN INSURANCE COMPANY | $131 | $0 | $131 | 1.15% |
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 | 768 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 776 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 483 | $3.2M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 768 | $288K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 768 | $255K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 768 | $299K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 36 | $56K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 768 | $255K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 483 | $3.2M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 768 | $311K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 768 | — |
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.