| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 39000 SAN FRANCISCO, CA 94139 | BLUE CROSS OF CALIFORNIA | $0 | $7K | $7K | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO NSURANCE SERVICES USA | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | PREMIER ACCESS INSURANCE COMPANY | $9K | $0 | $9K | 2.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 301 EAST PINE STREET SUITE 240 ORLANDO, FL 32801 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.99% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.79% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 45 FREMONT STREET SUITE 800 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $722 | $29 | $751 | 1.49% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE SUITE 100 RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $61 | $0 | $61 | 0.12% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $4 | $4 | 0.01% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $650 | $0 | $650 | 7.93% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 45 FREMONT STREET SUITE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $241 | $1 | $242 | 2.95% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 3440 WALNUT AVENUE 2ND FLOOR FREMONT, CA 94538 | HYATT LEGAL PLANS | $416 | $0 | $416 | 10.06% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | HYATT LEGAL PLANS | $0 | $57 | $57 | 1.38% |
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 | 525 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 534 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 834 | $3.8M |
| Dental(2 contracts, 2 carriers) | PREMIER ACCESS INSURANCE COMPANY | 1,053 | $597K |
| Vision | ARMADACARE | 33 | $163K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 524 | $224K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 180 | $50K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 524 | $173K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 834 | $3.7M |
| Other(5 contracts, 5 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 560 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,053 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.