| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 701 B ST STE 600 SAN DIEGO, CA 92101 | BLUE CROSS BLUE SHIELD OF ARIZONA | $49K | — | $49K | 15.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF S CALIFORNIA INS S | 38 DISCOVERY STE 250 IRVINE, CA 92618 | BLUE CROSS BLUE SHIELD OF ARIZONA | $14K | — | $14K | 4.41% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST 6TH FLOOR SAN DIEGO, CA 92101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 4.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62683 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 1.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CALIFORNIA | INSURANCE SER PO BOX 62683 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 1.33% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | ATTN ERICA MENDEZ 2415 E CAMELBACK RD STE 420 PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $242 | $5K | 9.76% |
| AGIS NETWORK INC3 | 2122 KRATKY RD ST LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $212 | $5K | 9.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $717 | — | $717 | 1.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B ST FL 6 SAN DIEGO, CA 921018101 | VISION SERVICE PLAN | $1K | — | $1K | 6.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3727 NORFOLK, VA 57130 | VISION SERVICE PLAN | $571 | — | $571 | 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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 183 | $315K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 183 | $333K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 192 | $119K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 192 | $119K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 192 | $119K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 183 | $315K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 183 | $315K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 180 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.