| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $133K | $324 | $133K | 5.35% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | $0 | $13K | 2.12% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $34K | $0 | $34K | 7.64% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS | UNKNOWN FOSTER CITY, CA 94404 | COMBINED INSURANCE COMPANY | $10K | $0 | $10K | 13.35% |
| USI INSURANCE SERVICES LLC3 | 1001 GALAXY WAY, SUITE 300 CONCORD, CA 94520 | COMBINED INSURANCE COMPANY | $6K | $0 | $6K | 7.62% |
| MJR INSURANCE SERVICES LLC3 Filed as: MJR INSURANCE SERVICES, LLC | 5444 SEPULVEDA BOULEVARD APARTMENT 106 SHERMAN OAKS, CA 91411 | AFLAC | $906 | $0 | $906 | 3.82% |
| MICHAEL BREITNER3 Filed as: MICHAEL BREITNER AND OTHER AGENTS | 2518 1/2 WEST CLARK AVENUE BURBANK, CA 91505 | AFLAC | $521 | $0 | $521 | 2.20% |
| USI INSURANCE SERVICES LLC3 | 2800 WEST MARCH LANE, SUITE 100 STOCKTON, CA 95219 | AFLAC | $430 | $0 | $430 | 1.81% |
| MICHAEL JOHN RINKE3 | 5444 SEPULVEDA BOULEVARD APARTMENT 106 CAMARILLO, CA 93011 | AFLAC | $424 | $0 | $424 | 1.79% |
| KEVIN MICHAEL NAGLE3 | 32 ESPERANZA AVENUE, APARTMENT F SIERRA MADRE, CA 91024 | AFLAC | $356 | $0 | $356 | 1.50% |
| RENEE SUZANNE CORSO3 | 16000 VENTURA BOULEVARD, SUITE 1120 ENCINO, CA 91436 | AFLAC | $250 | $0 | $250 | 1.05% |
| L MATTHEW SPALDING3 Filed as: L. MATTHEW SPALDING | 847 NORTH HOLLYWOOD WAY, SUITE 204 BURBANK, CA 91505 | AFLAC | $157 | $0 | $157 | 0.66% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | CALIFORNIA DENTAL NETWORK, INC. | $528 | $0 | $528 | 10.00% |
| USI INSURANCE SERVICES LLC3 | 1001 GALAXY WAY, SUITE 300 CONCORD, CA 94520 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $528 | $0 | $528 | 14.99% |
| WILLIAM S. BORDEN4 Filed as: WILLIAM'S BORDEN | 10057 VAN BROCKLIN WAY ELK GROVE, CA 95757 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $72 | $0 | $72 | 5.85% |
| USI INSURANCE SERVICES LLC3 | 1001 GALAXY WAY, SUITE 300 CONCORD, CA 94520 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $167 | $0 | $167 | 15.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $47 | $0 | $47 | — |
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 | 339 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 341 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 300 | $3.1M |
| Dental(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $452K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $446K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $446K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $470K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 339 | $446K |
| Prescription drug(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 300 | $3.1M |
| Other(6 contracts, 6 carriers) | AETNA LIFE INSURANCE COMPANY | 339 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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.