| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $68K | $0 | $68K | 3.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $9K | $882 | $10K | 5.94% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | PO BOX 350 CONSHOHOCKEN, PA 19428 | BLUE CROSS OF CALIFORNIA | $101 | $797 | $898 | 0.56% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | $0 | $12 | $12 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $0 | $13K | 17.34% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | -$68 | $0 | -$68 | -0.09% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 33213 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | $0 | $7K | 10.72% |
| JACQUELYN E. K. HOLDER3 Filed as: JACQUELYN ELIZABETH KIMUKO HOLDER | 9625 MISSION GORGE ROAD SUITE B2-304 SANTEE, CA 92071 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 7.65% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 2.21% |
| HEATHER SIEMS3 | 8859 LASSIE LANE SAN DIEGO, CA 92123 | CONTINENTAL AMERICAN INSURANCE COMPANY | $984 | $0 | $984 | 1.60% |
| TIFFANY A TREVINO3 Filed as: TIFFANY A. TREVINO AND OTHER AGENTS | 6718 BARNHURST SAN DIEGO, CA 92117 | CONTINENTAL AMERICAN INSURANCE COMPANY | $881 | $0 | $881 | 1.43% |
| STEPHANIE MARIE DERAN3 | 1059 EAST BRADLEY AVENUE, SUITE 102 EL CAJON, CA 92021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $637 | $0 | $637 | 1.03% |
| WHITNEY L MILLWOOD3 Filed as: WHITNEY L. MILLWOOD | 1763 FIDDLERS RIDGE DRIVE FLEMING ISLAND, FL 32003 | CONTINENTAL AMERICAN INSURANCE COMPANY | $600 | $0 | $600 | 0.97% |
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 | 363 | 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) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS OF CALIFORNIA | 582 | $2.0M |
| Dental(2 contracts) | BLUE CROSS OF CALIFORNIA | 582 | $2.0M |
| Vision(2 contracts) | BLUE CROSS OF CALIFORNIA | 582 | $2.0M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 352 | $76K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 352 | $76K |
| Prescription drug(2 contracts) | BLUE CROSS OF CALIFORNIA | 582 | $2.0M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 352 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 582 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.