| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 840 GESSNER ROAD, SUITE 600 HOUSTON, TX 77024 | CALIFORNIA PHYSICIANS SERVICE | $46K | $0 | $46K | 3.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 840 GESSNER ROAD, SUITE 600 HOUSTON, TX 77024 | KAISER FOUNDATION HEALTH PLAN INC | $22K | $0 | $22K | 3.19% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 10.00% |
| ANCO INS. SVC. OF BRYAN COLLEGE STA3 Filed as: ANCO INSURANCE SERVICES | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $733 | $16K | 10.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 1.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | VISION SERVICE PLAN | $4K | $0 | $4K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 3635 RIVERSIDE PLAZA DRIVE SUITE 320 RIVERSIDE, CA 92506 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $518 | $0 | $518 | 3.31% |
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 | 248 | 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) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 281 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 237 | $207K |
| Vision | VISION SERVICE PLAN | 253 | $40K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 248 | $153K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 248 | $153K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 248 | $153K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 281 | $2.2M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 248 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.