| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $282K | $7K | $289K | 3.59% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 350 CONSHOHOCKEN, PA 19428 | BLUE CROSS OF CALIFORNIA | $235 | $0 | $235 | 0.00% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS, LLC | 9370 SKY PARK COURT, SUITE 250 SAN DIEGO, CA 92123 | RELIASTAR LIFE INSURANCE COMPANY | $21K | $0 | $21K | 18.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | RELIASTAR LIFE INSURANCE COMPANY | $9K | $0 | $9K | 7.78% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | RELIASTAR LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.21% |
| VICTOR RODRIGUEZ4 | 12 STONEBROOK IRVINE, CA 92620 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 7.76% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 85638 SAN DIAGO, CA 92186 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $496 | $0 | $496 | 3.66% |
| USI INSURANCE SERVICES LLC4 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $301 | $0 | $301 | 2.22% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, SUITE 1 FLORHAM PARK, NJ 07932 | HARTFORD LIFE AND ACCIDENT | $1K | $0 | $1K | 12.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | LOCKBOX 740659 LOS ANGELES, CA 90074 | HARTFORD LIFE AND ACCIDENT | $30 | $0 | $30 | 0.26% |
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 | 626 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 34 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 667 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1,105 | $8.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 1,105 | $8.0M |
| Vision | BLUE CROSS OF CALIFORNIA | 1,105 | $8.0M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,105 | $8.1M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 1,105 | $8.0M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 1,105 | $8.0M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 1,105 | $8.0M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 1,105 | $8.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,105 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.