| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | $0 | $7K | 3.80% |
| ROBIN D. HUDSON AND OTHER AGENTS3 | 687 14TH STREET, APARTMENT F ASTORIA, OR 97103 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 3.43% |
| PAULINE M. SIMPSON3 | 3546 BEN LANE STOCKTON, CA 95206 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.36% |
| GUSTAVO ARRIAGA II3 Filed as: GUSTAVO ARRIAGA, II | 5237 NORTH RIVERSIDE DRIVE SUITE 207 FORT WORTH, TX 76137 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 0.83% |
| ANA PATRICIA ARRIAGA3 | 980 ARLINGTON CIRCLE WOODLAND, CA 95695 | CONTINENTAL AMERICAN INSURANCE COMPANY | $745 | $0 | $745 | 0.41% |
| MARJORIE B. YACOPETTI3 | PO BOX 2152 LODI, CA 95242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $708 | $0 | $708 | 0.39% |
| NEAL E. DAILY3 | 1852 WEST 11TH TRACY, CA 95376 | CONTINENTAL AMERICAN INSURANCE COMPANY | $675 | $0 | $675 | 0.37% |
| USI INSURANCE SERVICES LLC3 | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | AFLAC | $3K | $0 | $3K | 4.41% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO M. NAMBO AND OTHER AGENTS | 2175 57TH AVENUE SACRAMENTO, CA 95822 | AFLAC | $3K | $10 | $3K | 4.31% |
| PAULINE M. SIMPSON3 | 2726 TAMARISK AVENUE STOCKTON, CA 95207 | AFLAC | $1K | $22 | $1K | 1.84% |
| GUSTAVO ARRIAGA II3 Filed as: GUSTAVO ARRIAGA, II | 5237 NORTH RIVERSIDE DRIVE SUITE 207 FORT WORTH, TX 76137 | AFLAC | $862 | $0 | $862 | 1.20% |
| BETH A. HESTER3 | 1143 CHAMPAGNE LANE MANTECA, CA 95337 | AFLAC | $607 | $0 | $607 | 0.84% |
| NEAL E. DAILY3 | 1852 WEST 11TH STREET, SUITE 310 TRACY, CA 95376 | AFLAC | $562 | $0 | $562 | 0.78% |
| ANA PATRICIA ARRIAGA3 | 980 ARLINGTON CIRCLE WOODLAND, CA 95695 | AFLAC | $392 | $0 | $392 | 0.54% |
| USI INSURANCE SERVICES LLC4 | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 6.41% |
| MARK MCDONALD4 Filed as: MARK D. MCDONALD | 1365 SEACOAST DRIVE, UNIT M IMPERIAL BEACH, VT 91932 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 3.71% |
| THE SAMSON GROUP4 Filed as: THE SAMSON GROUP AND OTHER AGENTS | 18 GREENGATE COURT SANTA ROSA, CA 95409 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $194 | $0 | $194 | 0.72% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP, INC. | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $165 | $0 | $165 | 0.61% |
| LISA L BASS4 Filed as: LISA L. BASS | 16973 BRIDGETON LANE HUNTERSVILLE, NC 28078 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $162 | $0 | $162 | 0.60% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $145 | $0 | $145 | 0.54% |
| RYAN C ELLISON4 Filed as: RYAN C. ELLISON | 381 EAST HEDGE HOLLOW COVE DRAPER, UT 84020 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $85 | $0 | $85 | 0.32% |
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 | 1,124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,512 | $187K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 1,256 | $254K |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,512 | $468K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,512 | — |
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.