| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $105K | $7K | $111K | 4.18% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | $25K | $2K | $26K | 10.04% |
| USI INSURANCE SERVICES LLC3 | 320 FEDERAL STREET BLUEFIELD, WV 24701 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | $0 | $9K | 16.32% |
| CHRISTOPHER D. JUDY3 Filed as: CHRISTOPHER DALE JUDY | 12051 VERANO COURT SAN DIEGO, CA 92128 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 5.64% |
| JACQUELYN E. K. HOLDER3 Filed as: JACQUELYN ELIZABETH KINUKO HOLDER | 9625 MISSION GORGE ROAD SUITE B2-304 SANTEE, CA 92071 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 3.30% |
| MYKISHA L. THOMAS3 Filed as: MYKISHA LIEIESHA THOMAS | 3886 3RD AVENUE LOS AGENELS, CA 90008 | CONTINENTAL AMERICAN INSURANCE COMPANY | $697 | $0 | $697 | 1.30% |
| TIFFANY A TREVINO3 Filed as: TIFFANY ANNE TREVINO | 6718 BARNHURST SAN DIEGO, CA 92117 | CONTINENTAL AMERICAN INSURANCE COMPANY | $395 | $0 | $395 | 0.74% |
| HEATHER SIEMS3 | 8220 UNVIERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | CONTINENTAL AMERICAN INSURANCE COMPANY | $258 | $0 | $258 | 0.48% |
| STEPHANIE MARIE DERAN3 Filed as: STEPHANIE DERAN AND OTHER AGENTS | 1059 EAST BRADLEY AVENUE, SUITE 102 EL CAJON, CA 92021 | CONTINENTAL AMERICAN INSURANCE COMPANY | -$3K | $0 | -$3K | -5.31% |
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 | 300 | 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) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 229 | $2.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $263K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $263K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $263K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $263K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 229 | $2.7M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 472 | — |
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.