| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $26K | $0 | $26K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PREMIER ACCESS INSURANCE COMPANY | $7K | $0 | $7K | 10.23% |
| USI INSURANCE SERVICES LLC3 | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 13.17% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $316 | $316 | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3440 WALNUT, BLDG A, 2ND FLOOR SUITE 33667 FREMONT, CA 94538 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $679 | $0 | $679 | 10.11% |
| USI INSURANCE SERVICES LLC3 | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $0 | $152 | 2.67% |
| STEVE BAKER4 | 153 ESTEHER DRIVE COCOA BEACH, FL 32931 | LEGAL SHIELD | $450 | $0 | $450 | 33.78% |
| USI INSURANCE SERVICES LLC4 | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | LEGAL SHIELD | $106 | $0 | $106 | 7.96% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTERN HEALTH ADVANTAGE | 92 | $521K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 118 | $65K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 93 | $7K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 79 | $49K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 79 | $44K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 79 | $44K |
| Prescription drug | WESTERN HEALTH ADVANTAGE | 92 | $521K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.