| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN DALLAS, TX 75204 | BLUECROSS BLUESHIELD OF MASSACHUSETTS, INC. | $48K | — | $48K | 2.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $0 | $25K | $25K | 4.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | COMBINED INSURANCE COMPANY OF AMERICA | $79K | $0 | $79K | 21.07% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY, LLC | 1901 ROXBOROUGH ROAD, SUITE 300 CHARLOTTE, NC 28211 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 7.76% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.78% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, LLC | 1820 EAST FIRST STREET SUITE 400 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.97% |
| JAMES D DAVIDSON3 Filed as: JAMES D. DAVIDSON | 1820 EAST 1ST STREET SUITE 400 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $298 | $0 | $298 | 0.20% |
| ROBLES JENNIFER3 | 1002 NORTH TEXAS STREET FAIRFIELD, CA 94533 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $282 | $0 | $282 | 0.19% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $30 | $0 | $30 | 0.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $28 | $0 | $28 | 0.02% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SVCS. | 29840 NETWORK PLACE CHICAGO, IL 60673 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | $0 | $24 | 0.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | RELIASTAR LIFE INSURANCE COMPANY | $14K | $0 | $14K | 10.58% |
| BSC AGENCY LLC3 Filed as: BSC AGENCY, LLC | 1025 ASHWORTH ROAD WEST DES MOINES, IA 50265 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $5K | $5K | 4.00% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | RELIASTAR LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.17% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $1K | $0 | $1K | 0.86% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 1800 SW FIRST AVENUE PORTLAND, OR 97201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 7.75% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $665 | $0 | $665 | 2.45% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $213 | $0 | $213 | 0.79% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $142 | $0 | $142 | 0.52% |
| MARK TETSUO IWASAKI3 Filed as: MARK TETSUO IWASAKI AND OTHER AGNTS | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $59 | $0 | $59 | 0.22% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SVCS. | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $0 | $46 | 0.17% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. AND OTHERS | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | $0 | $39 | 0.14% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK ROAD PLANT CITY, FL 33567 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.10% |
| DEBORAH LYNN WELLS3 | 5809 MARK TWAIN AVENUE SACRAMENTO, CA 95820 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.08% |
| BRIAN COHEN3 | 6804 NORTH CAPITAL TEXAS HIGHWAY APARTMENT 221 AUSTIN, TX 78731 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.06% |
| NASH ROBERT3 | 139 LABARQUE WAY EUREKA, MO 63025 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $62 | $0 | $62 | 1.72% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, LLC | 1820 EAST FIRST STREET SUITE 400 SANTA ANA, CA 92705 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $26 | $0 | $26 | 0.72% |
| WILLIAM R. POPE3 | 3395 FALLING BROOK DRIVE MARIETTA, GA 30062 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $12 | $0 | $12 | 0.33% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $5 | $0 | $5 | 0.14% |
| JOHN R. PIERSALL3 | 8817 EAST SANDPIPER DRIVE INVERNESS, FL 34450 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $4 | $0 | $4 | 0.11% |
| ROD L STENSEN3 Filed as: ROD L. STENSEN | 2052 MAIDU WAY GOLD RIVER, CA 95670 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $2 | $0 | $2 | 0.06% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 1800 SW FIRST AVENUE PORTLAND, OR 97201 | THE PAUL REVERE LIFE INSURANCE COMPANY | $225 | $0 | $225 | 7.50% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | THE PAUL REVERE LIFE INSURANCE COMPANY | $56 | $0 | $56 | 1.87% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | THE PAUL REVERE LIFE INSURANCE COMPANY | $22 | $0 | $22 | 0.73% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | THE PAUL REVERE LIFE INSURANCE COMPANY | $15 | $0 | $15 | 0.50% |
| DANA SUMMERS3 | 259 OVERLAND TRL HAYS, NC 28635 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13 | $0 | $13 | 0.43% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | THE PAUL REVERE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.27% |
| EVELYN GARCIA3 | 421 EAST 82ND STREET, BASEMENT A NEW YORK, NY 10028 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.13% |
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 | 6,082 | 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) | 6,082 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 6,082 | $12.1M |
| Dental | BLUECROSS BLUESHIELD OF MASSACHUSETTS, INC. | 167 | $2.3M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 4,180 | $575K |
| Life insurance(6 contracts, 6 carriers) | SECURIAN LIFE INSURANCE COMPANY | 6,082 | $1.2M |
| Short-term disability(5 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 3,321 | $1.1M |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 3,321 | $875K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 6,082 | $12.1M |
| Other(6 contracts, 6 carriers) | SECURIAN LIFE INSURANCE COMPANY | 6,082 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,082 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.