| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | $3K | $15K | 24.53% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $2K | $8K | 12.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | $0 | $9K | 15.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.43% |
| SHANIKA M. FISKE3 | 21552 MORESBY WAY LAKE FOREST, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $20 | $1K | 4.44% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $2 | $1K | 4.08% |
| SAMAR BREIK ALBIN3 Filed as: SAMAR BREIK ALBIN AND OTHER AGENTS | 41572 VALOR DRIVE MURRIETA, CA 92562 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $668 | $5 | $673 | 2.20% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $350 | $88 | $438 | 1.43% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BENEFITS, LLC | 1301 DOVE STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $231 | $154 | $385 | 1.26% |
| DAVID MASON DOKELL3 | 159 BEACON DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $321 | $0 | $321 | 1.05% |
| CRYSTAL BAY INSURANCE SERVICES, LLC3 | 7545 IRVINE CENTER DRIVE IRVINE, CA 92618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $124 | $0 | $124 | 0.41% |
| USI INSURANCE SERVICES LLC3 | 100 NORTH MAIN STREET WINSTON-SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.00% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 130 | $57K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 115 | $16K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $60K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $60K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $60K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.