| 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 | $58K | $0 | $58K | 1.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 0.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $39K | $0 | $39K | 8.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $9K | $9K | 2.06% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $84 | $84 | 0.02% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $61 | $61 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24K | $4K | $28K | 43.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | VISION SERVICE PLAN | $1K | $0 | $1K | 2.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $546 | $0 | $546 | 1.19% |
| CLAUDIA S. CHAMORRO3 | PO BOX 22481 SAN DIEGO, CA 92192 | AFLAC | $1K | $273 | $1K | 3.90% |
| SUZAN MARIE PEEL AND OTHER AGENTS3 | 1120 PEPPER DRIVE, SPACE 120 EL CAJON, CA 92021 | AFLAC | $1K | $0 | $1K | 2.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | AFLAC | $530 | $0 | $530 | 1.52% |
| CHRISTOPHER L KENNEDY3 Filed as: CHRISTOPHER L. KENNEDY | 2888 LOKER AVENUE EAST, SUITE 210 CARLSBAD, CA 92010 | AFLAC | $395 | $58 | $453 | 1.30% |
| SUSAN C. HAMA3 | 7778 PASEO LA JOLLA CARLSBAD, CA 92009 | AFLAC | $278 | $0 | $278 | 0.80% |
| OVERBECK INSURANCE SERVICES3 | 479 NORTH HARLEM AVENUE APARTMENT 1301 OAK PARK, IL 60301 | AFLAC | $175 | $33 | $208 | 0.60% |
| SMP INSURANCE SERVICES INC.3 | 1120 PEPPER DRIVE, SPACE 120 EL CAJON, CA 92021 | AFLAC | $201 | $0 | $201 | 0.58% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HEALTH AND HUMAN RESOURCE CENTER, INC. | $350 | $0 | $350 | 6.59% |
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 | 503 | 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) | 503 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 860 | $6.5M |
| Dental(3 contracts, 3 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 412 | $914K |
| Vision(3 contracts, 3 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 408 | $895K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 503 | $449K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 503 | $449K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 503 | $449K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 860 | $6.5M |
| Other(4 contracts, 4 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 719 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 860 | — |
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.