| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN RAY GRIFFIN3 Filed as: STEVEN R. GRIFFIN | 2000 MORRIS AVENUE SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42K | -$14 | $42K | 9.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CA | 2201 EAST CAMELBACK ROAD SUITE 220A PHOENIX, AZ 85016 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 2.38% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN R. GRIFFIN | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36K | $4K | $41K | 13.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CA | 2201 EAST CAMELBACK RD., SUITE 220A PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 2.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CA | 2201 EAST CAMELBACK ROAD SUITE 220A PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 5.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CA | 2201 EAST CAMELBACK ROAD SUITE 220A PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $467 | $10K | 15.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CA | 2201 EAST CAMELBACK ROAD SUITE 220A PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $372 | $8K | 15.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $617K |
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $55K |
| USI OF SOUTHERN CA INS SVS INC EIN 86-0708729 BROKER | Other commissions Service code 55 | — | $5K |
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 | 3,098 | 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) | 3,098 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 7,759 | $485K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,413 | $197K |
| Short-term disability(4 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 5,482 | $923K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,413 | $135K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 7,759 | $485K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 444 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,759 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.