| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | UNITEDHEALTHCARE INSURANCE COMPANY | $60K | $177 | $60K | 0.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $29K | $29K | 0.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $61K | $0 | $61K | 6.06% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $40K | $4K | $45K | 9.38% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $224 | $224 | 0.05% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | $0 | $22K | 34.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.21% |
| CLAUDIA S. CHAMORRO3 | PO BOX 22481 SAN DIEGO, CA 92192 | AFLAC | $2K | $453 | $3K | 7.60% |
| JILLIAN OVERBECK AND OTHER AGENTS3 | 3120 CAMINITO RICARDO, SUITE 210 ENCINITAS, CA 92024 | AFLAC | $1K | $48 | $1K | 4.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | AFLAC | $1K | $0 | $1K | 3.48% |
| CHRISTOPHER L KENNEDY3 Filed as: CHRISTOPHER L. KENNEDY | 2888 LOKER AVENUE EAST, SUITE 210 CARLSBAD, CA 92010 | AFLAC | $658 | $96 | $754 | 2.14% |
| SUSAN C. HAMA3 | 7778 PASEO LA JOLLA CARLSBAD, CA 92009 | AFLAC | $321 | $66 | $387 | 1.10% |
| SMP INSURANCE SERVICES INC.3 Filed as: SMP INSURANCE SERVICES, INC. | 1120 PEPPER DRIVE, SPACE 120 EL CAJON, CA 92021 | AFLAC | $344 | $0 | $344 | 0.98% |
| JD HOLDER ENTERPRISES INC3 Filed as: JD HOLDER ENTERPRISES, INC. | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $118 | $0 | $118 | 0.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HEALTH AND HUMAN RESOURCE CENTER, INC. | $1K | $0 | $1K | 5.40% |
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 | 564 | 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) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 980 | $7.4M |
| Dental(3 contracts, 3 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 466 | $1.1M |
| Vision(3 contracts, 3 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 456 | $1.1M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 564 | $476K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 564 | $476K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 564 | $476K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 980 | $7.4M |
| Other(4 contracts, 4 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 625 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 980 | — |
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."
No prospect flags tripped on this filing.