| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $20K | $0 | $20K | 2.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | BLUE CROSS OF CALIFORNIA | $9K | $0 | $9K | 1.19% |
| USI INSURANCE SERVICES LLC3 | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | AMERITAS LIFE INSURANCE CORPORATION | $1K | $0 | $1K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $543 | $543 | 5.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $171 | $1K | 13.85% |
| ALAINE S. VANNESS3 Filed as: ALAINE VANNESS | 1217 SOUTH SCHOOL STREET LODI, CA 95240 | AFLAC | $224 | $0 | $224 | 4.02% |
| DAVID B. KITCHEN3 Filed as: DAVID KITCHEN | 1260 NORTH DUTTON AVENUE, SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $128 | $0 | $128 | 2.30% |
| PETER JAMES SARANTIS3 Filed as: PETER SARANTIS | 26200 TOWN CENTER DRIVE, SUITE 110 NOVI, MI 48375 | AFLAC | $60 | $0 | $60 | 1.08% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN INSURANCE SERVICES, INC | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $25 | $0 | $25 | 0.45% |
| MICHAEL RHODD3 | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $7 | $0 | $7 | 0.13% |
| AMY LUDWICK3 | 7403 SESAME STREET COLUMBUS, GA 31909 | AFLAC | $7 | $0 | $7 | 0.13% |
| MARITZA SANTIAGO3 | 1330 KEARNEY AVENUE, 2ND FLOOR BRONX, NY 10465 | AFLAC | $86 | $0 | $86 | 4.63% |
| ALAINE S. VANNESS3 Filed as: ALAINE VANNESS | 1217 SOUTH SCHOOL STREET LODI, CA 95240 | AFLAC | $37 | $0 | $37 | 1.99% |
| PERRY E MEDINA3 Filed as: PERRY MEDINA | 30 DOROTHY DRIVE MONROE, NY 10950 | AFLAC | $20 | $0 | $20 | 1.08% |
| MICHELLE SANTIAGO3 | 1332 KEARNEY AVENUE, APARTMENT 2 BRONX, NY 10465 | AFLAC | $10 | $0 | $10 | 0.54% |
| MCINERNEY GROUP LLC3 Filed as: MCINERNEY GROUP, LLC | 580 WHITE PLAINS ROAD, SUITE 115 TARRYTOWN, NY 10591 | AFLAC | $6 | $0 | $6 | 0.32% |
| MELISA SCHOFIELD3 | 932 EAST VOLKIN LANE MIDDLETOWN, CT 06457 | AFLAC | $2 | $0 | $2 | 0.11% |
| WENDY CALIENDO3 | 1036 MAGGIE ROAD NEWBURGH, NY 12550 | AFLAC | $1 | $0 | $1 | 0.05% |
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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 159 | $736K |
| Dental | BLUE CROSS OF CALIFORNIA | 159 | $736K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 191 | $11K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $10K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 159 | $736K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.