| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 312 ELM ST 24TH FLOOR CINCINNATI, OH 45202 | SYMETRA LIFE INSURANCE COMPANY | — | $18K | $18K | 2.43% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SRVS | 1850 MT DIABLE BLVD #430 WALNUT CREEK, CA 94596 | SYMETRA LIFE INSURANCE COMPANY | $18K | — | $18K | 19.87% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | AON COMPANY 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.84% |
| DAUGHERTY & COMPANY INS BROKERS INC3 | 2495 W MARCH LN S-200 PO BOX 7369 STOCKTON, CA 95207 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $1 | $31 | 0.07% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAM | AON COMPANY 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $46 | — | $46 | 4.32% |
| DAUGHERTY & COMPANY INS BROKERS INC3 | 2495 W MARCH LN S-200 PO BOX 7369 STOCKTON, CA 95207 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 0.19% |
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 | 1,713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,721 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 1,885 | $14.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 354 | $65K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 2,787 | $790K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 2,787 | $742K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 1,885 | $14.6M |
| Other(3 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 2,787 | $835K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,787 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.