| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $74K | $0 | $74K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $0 | $8K | 2.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $4K | $12K | 10.98% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $411 | $411 | 0.37% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA INSURANCE COMPANY | $7K | $710 | $8K | 11.04% |
| LAURA RUNYEON3 | 981 QUARRY STREET PETALUMA, CA 94954 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $456 | $3K | 10.20% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $35 | $2K | 8.01% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $280 | $95 | $375 | 1.36% |
| DARRYL W VIDOR3 Filed as: DARRYL W. VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $351 | $0 | $351 | 1.27% |
| MIKAELA MARIE WOOD3 | 1087 TWINBERRY STREET PLUMAS LAKE, CA 95961 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $293 | $0 | $293 | 1.06% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $203 | $0 | $203 | 0.73% |
| ONE SOURCE ADVISORS, LLC AND AGENTS3 | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $9 | $93 | 0.34% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $216 | $2K | 11.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.04% |
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 | 272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 268 | $1.9M |
| Dental(3 contracts, 3 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 165 | $120K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 231 | $21K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 272 | $139K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 272 | $139K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 272 | $111K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 268 | $1.9M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 272 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.