| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1390 WILLOW PASS ROAD, SUITE 410 CONCORD, CA 94520 | AETNA HEALTH, INC. | $63K | $0 | $63K | 4.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA HEALTH, INC. | $0 | $8K | $8K | 0.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 WEST VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $20K | $0 | $20K | 9.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1390 WILLOW PASS ROAD, SUITE 410 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 4.40% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISIORS | 1936 EAST DEERE AVENUE SANTA ANA, CA 92705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 4.49% |
| ROSS PENDERGRAFT3 | 16622 CALAHAN STREET NORTH HILLS, CA 91343 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $413 | $0 | $413 | 1.38% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $299 | $0 | $299 | 1.00% |
| JC MEDINA CORPORATION3 | 2021 NORTH BEVERLY PLAZA LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $144 | $0 | $144 | 0.48% |
| MARIA CRISTINA MORALES TREJO3 Filed as: MARIA CHRISTINA MORALES TREJO | 1919 SHERRY LANE SANTA ANA, CA 92705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $0 | $94 | 0.31% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
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 | 316 | 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) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 271 | $1.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 351 | $198K |
| Vision | BLUE CROSS OF CALIFORNIA | 351 | $198K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 351 | $213K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 271 | $1.5M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 351 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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.