| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | P.O. BOX 62949 ATTN WEST VIRGINIA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | -$21K | $0 | -$21K | -1.12% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FNCL SVCS | 2111 E HIGHLAND AVE SUITE B210 PHOENIX, AZ 85016 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $30K | $10K | $40K | 17.68% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FNCL SVCS | 2111 E HIGHLAND AVE SUITE B210 PHOENIX, AZ 85016 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | $3K | $12K | 18.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 95-4331852 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Other fees; Contract Administrator Service code 12 | — | $2.0M |
| WORD & BROWN EIN 95-3161239 NONE | Insurance agents and brokers Service code 22 | — | $1.4M |
| USI INSURANCE SERVICES LLC EIN 13-3771734 CONTRACT ADMINISTRATOR | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | — | $786K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $227K |
| DELOITTE CONSULTING LLP EIN 13-5133500 ACTUARY | Actuarial; Consulting (general) Service code 11 | — | $169K |
| ROGERS BENEFIT GROUP, INC. EIN 41-1596522 NONE | Insurance agents and brokers Service code 22 | — | $135K |
| DELTA DENTAL EIN 94-1461312 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $123K |
| CHRISTINE SIMMONS NONE | Insurance agents and brokers Service code 22 | PO BOX 8052 NEWPORT BEACH, CA 92658 | $99K |
| LISI, INC. EIN 94-2757978 NONE | Insurance agents and brokers Service code 22 | — | $96K |
| KEVIN A. ROBERTS NONE | Insurance agents and brokers Service code 22 | 3658 MOSSWOOD DRIVE LAFAYETTE, CA 94549 | $86K |
| MERCER EIN 13-2834414 NONE | Insurance agents and brokers Service code 22 | — | $81K |
| MUFG UNION BANK, N.A. EIN 94-0304288 NONE | Investment management fees paid indirectly by plan; Account maintenance fees Service code 52 | — | $74K |
| CALCPA EIN 94-1056137 PLAN SPONSOR | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $71K |
| CONSUMERMEDICAL EIN 04-3367006 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $71K |
| ARMANINO LLP EIN 94-6214841 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $67K |
| ALEC ABBOTT EIN 03-3428814 NONE | Insurance agents and brokers Service code 22 | — | $66K |
| JASON PERKINS EIN 54-8915205 NONE | Insurance agents and brokers Service code 22 | — | $66K |
| MICHAEL B. KELLY INSURANCE SERVICES EIN 30-0540100 NONE | Insurance agents and brokers Service code 22 | — | $55K |
| CRAIG TOMPKINS NONE | Insurance agents and brokers Service code 22 | 969-G EDGEWATER BLVD #762 FOSTER CITY, CA 94404 | $52K |
| VISION SERVICE PLAN EIN 94-1632821 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $48K |
| MCLERAN MARKETING, LLC EIN 47-1793819 NONE | Other fees Service code 99 | — | $47K |
| RSC INSURANCE BROKERAGE, INC EIN 16-1689464 NONE | Insurance agents and brokers Service code 22 | — | $47K |
| HOVER INSURANCE SERVICES, INC. EIN 77-0096773 NONE | Insurance agents and brokers Service code 22 | — | $42K |
| HUB INTERNATIONAL INSURANCE SERVICE EIN 33-0315047 NONE | Insurance agents and brokers Service code 22 | — | $41K |
| CHRISTOPHER J. FLETCHER NONE | Insurance agents and brokers Service code 22 | 45 RESEARCH WAY SUITE 106 EAST SETAUKET, NY 11733 | $40K |
| MANIACI INSURANCE SERVICES, INC. EIN 95-3562557 NONE | Insurance agents and brokers Service code 22 | — | $40K |
| MARSH USA EIN 36-1436000 NONE | Insurance agents and brokers Service code 22 | — | $38K |
| STRATEGIC ASSET ALLIANCE EIN 91-1629027 NONE | Investment advisory (plan) Service code 27 | — | $35K |
| SUN LIFE CAPITAL MANAGEMENT (U.S.) EIN 04-3401283 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $33K |
| EBIX, INC. EIN 77-0021975 NONE | Other fees Service code 99 | — | $30K |
| SEQUOIA BENEFITS AND INSURANCE SERV EIN 94-3397213 NONE | Insurance agents and brokers Service code 22 | — | $27K |
| BSWIFT, LLC EIN 36-4391310 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $27K |
| JAMES G. PARKER INSURANCE ASSOCIATE EIN 94-2494444 NONE | Insurance agents and brokers Service code 22 | — | $26K |
| RIGHT SIZE SOLUTIONS, INC. EIN 26-4067765 NONE | Other services Service code 49 | — | $24K |
| ALLIED WEALTH MANAGEMENT LLC EIN 47-4837341 NONE | Insurance agents and brokers Service code 22 | — | $22K |
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 NONE | Insurance agents and brokers Service code 22 | — | $22K |
| DIGITAL INSURANCE, INC. EIN 58-2522668 NONE | Insurance agents and brokers Service code 22 | — | $21K |
| PIGOTT FINANCIAL CORPORATION EIN 47-2791334 NONE | Insurance agents and brokers Service code 22 | — | $21K |
| MARSHALL PIERSON INC. EIN 20-0327643 NONE | Insurance agents and brokers Service code 22 | — | $16K |
| CBA PREMIER INSURANCE SOLUTIONS, IN EIN 46-1097216 NONE | Insurance agents and brokers Service code 22 | — | $16K |
| UNITEDAG, CASEHP-CA SMALL EMPLOYER EIN 33-0835612 NONE | Consulting (general) Service code 16 | — | $16K |
| RON FILICE ENTERPRISES, INC. EIN 77-0261203 NONE | Insurance agents and brokers Service code 22 | — | $14K |
| PENNBROOK INSURANCE SERVICES, INC. EIN 94-2800879 NONE | Insurance agents and brokers Service code 22 | — | $14K |
| MAROEVICH, O'SHEA & COGHLAN INSURAN EIN 94-2632373 NONE | Insurance agents and brokers Service code 22 | — | $14K |
| ALLIANT INSURANCE SERVICES, INC. EIN 47-9723395 NONE | Insurance agents and brokers Service code 22 | — | $13K |
| INTERWEST INSURANCE SERVICES, LLC EIN 68-0266090 NONE | Insurance agents and brokers Service code 22 | — | $12K |
| KAREN PREISSER NONE | Insurance agents and brokers Service code 22 | PO BOX 98 SHASTA, CA 96087 | $12K |
| JWCIB, INC. EIN 33-0515081 NONE | Insurance agents and brokers Service code 22 | — | $11K |
| ACRISURE OF CALIFORNIA EIN 38-3942950 NONE | Insurance agents and brokers Service code 22 | — | $10K |
| JASON RYAN SPROUSE NONE | Insurance agents and brokers Service code 22 | 1025 CALIMESA BLVD SUITE 1 CALIMESA, CA 92320 | $10K |
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 | 6,360 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 94 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,454 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 7,289 | $3.9M |
| Dental | DELTA CARE USA | 17 | $5K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 383 | $63K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 527 | $227K |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 7,289 | $1.9M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 383 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,289 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.