| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 575 MARKET STREET, SUITE 3750 SAN FRANCISCO, CA 94105 | WESTERN HEALTH ADVANTAGE | $8K | $0 | $8K | 2.00% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $16K | $0 | $16K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 11.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 4.05% |
| 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 | $2K | $2K | 3.17% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2 | $0 | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 4.51% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 6.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $108 | $108 | 0.56% |
| DWIGHT L PIERCE3 Filed as: DWIGHT L. PIERCE | 1200 EAST TAFT AVENUE SAPULPA, OK 74066 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.11% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.10% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 3100 EAST MIRALOMA AVENUE SUITE 240 ANAHEIM, CA 92806 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.06% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 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 | 184 | 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) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 47 | $723K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 142 | $54K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 162 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 184 | $80K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 55 | $19K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 184 | $61K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 47 | $723K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 184 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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."
No prospect flags tripped on this filing.