| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMP | 601 UNION ST STE 1000 SEATTLE, WA 98101 | SUNLIFE ASSURANCE COMPANY OF CANADA | — | $14K | $14K | 1.49% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMP | 3247 W MARCH LN STE 210 STOCKTON, CA 95219 | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMP | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES CORP | 200 SUMMIT LAKE DR STE 350 VALHALLA, NY 10595 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMP | 3247 W MARCH LN STE 210 STOCKTON, CA 95219 | AFLAC | $3K | — | $3K | 5.05% |
| PAULINE M. SIMPSON3 Filed as: PAULINE SIMPSON | 2726 TAMARISK AVE STOCKTON, CA 95207 | AFLAC | $1K | $123 | $1K | 1.99% |
| BETH A. HESTER3 Filed as: BETH A HESTER | 1143 CHAMPAGNE LN MANTECA, CA 95337 | AFLAC | $1K | $21 | $1K | 1.92% |
| GUSTAVO ARRIAGA II3 | 1140 MANGROVE AVE STE D CHICO, CA 95926 | AFLAC | $913 | $44 | $957 | 1.68% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO NAMBO | 2175 57TH AVE SACRAMENTO, CA 95822 | AFLAC | $553 | — | $553 | 0.97% |
| NEAL E. DAILY3 Filed as: NEAL E DAILY | 1852 W 11TH ST 310 TRACY, CA 95376 | AFLAC | $462 | $12 | $474 | 0.83% |
| FRANCISCO MALDONADO3 | 1242 TULLOCH DR TRACY, CA 95304 | AFLAC | $286 | $6 | $292 | 0.51% |
| ANA PATRICIA ARRIAGA3 | 980 ARLINGTON CIR WOODLAND, CA 95695 | AFLAC | $279 | — | $279 | 0.49% |
| MARJORIE B. YACOPETTI3 Filed as: MARJORIE YACOPETTI | PO BOX 2152 LODI, CA 95241 | AFLAC | $263 | — | $263 | 0.46% |
| JEANETTE YVONNE DURRANI | 1531 N ST APT 505 SACRAMENTO, CA 95814 | AFLAC | $183 | — | $183 | 0.32% |
| MELODY IRELAND3 | 5225 PENTECOST DR STE 24 MODESTO, CA 95356 | AFLAC | $176 | — | $176 | 0.31% |
| ANA PATRICIA ARRIAGA3 | 1115 GRAY AVE YUBA CITY, CA 95991 | AFLAC | $135 | $31 | $166 | 0.29% |
| HENRY IRELAND3 | 5225 PENTECOST DR STE 24 MODESTO, CA 95356 | AFLAC | $141 | — | $141 | 0.25% |
| MJ INSURANCE3 Filed as: ROBIN HUDSON | 15000 DAVIS LN APT 80 LAKE OSWEGO, OR 97035 | AFLAC | $111 | — | $111 | 0.19% |
| GUSTAVO ARRIAGA II3 | 5237 N RIVERSIDE DR STE 207 FORT WORTH, TX 76137 | AFLAC | $105 | — | $105 | 0.18% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $88 | — | $88 | 0.15% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $87 | — | $87 | 0.15% |
| JAMES SCHLERNITZAUER3 | 1175 GEER RD STE D TURLOCK, CA 95380 | AFLAC | $83 | — | $83 | 0.15% |
| ROBERT SWAIN3 | 9308 TAM O SHANTER DR STOCKTON, CA 95210 | AFLAC | $66 | — | $66 | 0.12% |
| GARY ALLAN PSOTKA3 Filed as: GARY KINSER | 10055 BOCA CIR PARKER, CO 80134 | AFLAC | $65 | — | $65 | 0.11% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $63 | — | $63 | 0.11% |
| ANA PATRICIA ARRIAGA3 | PO BOX 1131 WOODLAND, CA 95776 | AFLAC | $50 | $7 | $57 | 0.10% |
| WALTER REED3 | PO BOX 2487 MANTECA, CA 95336 | AFLAC | $27 | $11 | $38 | 0.07% |
| THEODORE CRANE3 | 2700 MARINA DR APT 109 MODESTO, CA 95355 | AFLAC | $36 | — | $36 | 0.06% |
| DON MUNDELLO JR3 | PO BOX 139 DENAIR, CA 95316 | AFLAC | $34 | — | $34 | 0.06% |
| MICHAEL BANTON3 | 18424 MCKINLEY AVE MANTECA, CA 95337 | AFLAC | $34 | — | $34 | 0.06% |
| JAMES FITZPATRICK3 | 1601 W ELM ST LODI, CA 95242 | AFLAC | $29 | — | $29 | 0.05% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 305 10TH ST SACRAMENTO, CA 95814 | AFLAC | $27 | — | $27 | 0.05% |
| DEBORAH CHAPIN3 | 2518 TELEGRAPH AVE STOCKTON, CA 95204 | AFLAC | $26 | — | $26 | 0.05% |
| MICHAEL BANTON3 | 1219 LOCUST AVENUE MANTECA, CA 95337 | AFLAC | $16 | $10 | $26 | 0.05% |
| JEWEL LOPEZ3 Filed as: JEWEL L LOPEZ | 1330 COOPER AVE TURLOCK, CA 95380 | AFLAC | $18 | — | $18 | 0.03% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER LYMAN SR | 8 S VOLUNTARIO ST UNIT A SANTA BARBARA, CA 93103 | AFLAC | $16 | — | $16 | 0.03% |
| GUILLERMO H PALOMINO3 Filed as: GUILLERMO PALOMINO | 21155 N 56TH ST APT 2120 PHOENIX, AZ 86054 | AFLAC | $15 | — | $15 | 0.03% |
| JONATHAN PAYNE3 | 3572 SHADOWTREE LN CHICO, CA 95928 | AFLAC | $15 | — | $15 | 0.03% |
| TANJORE SPLAN3 | 2101 MAID MARIANE LN MODESTO, CA 95355 | AFLAC | $13 | — | $13 | 0.02% |
| LAUREL NICOLE HARMS3 Filed as: LAUREL N HARMS | 785 TURRINI DR DANVILLE, CA 94526 | AFLAC | $11 | — | $11 | 0.02% |
| ROBERT PILKENTON3 | 1100 CORPORATE WAY STE 100 SACRAMENTO, CA 95831 | AFLAC | $11 | — | $11 | 0.02% |
| EDWARD M RYSKA3 Filed as: EDWARD RYSKA | 6010 ROBLAR RD PETALUMA, CA 94952 | AFLAC | $9 | — | $9 | 0.02% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 26200 TOWN CENTER DR STE 110 NOVI, MI 48375 | AFLAC | $6 | — | $6 | 0.01% |
| LISA M HUTCHERSON3 | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $6 | — | $6 | 0.01% |
| ROBERT PILKENTON3 | 1100 CORPORATE WAY STE 100 SACRAMENTO, CA 95831 | AFLAC | $6 | — | $6 | 0.01% |
| MAYRA CUARENTA3 | 620 EDGEBROOK CT MODESTO, CA 95354 | AFLAC | $3 | — | $3 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMP | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $414 | $414 | 0.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES CORP | 200 SUMMIT LAKE DR STE 350 VALHALLA, NY 10595 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE INSURANCE CO EIN 95-4331852 ADMINISTRATOR | Float revenue; Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $333K |
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 | 1,229 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,247 | $245K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,593 | $200K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,593 | $200K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 1,223 | $924K |
| Other | AFLAC | 256 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,593 | — |
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.