| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $30K | $0 | $30K | 4.99% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PREMIER ACCESS INSURANCE COMPANY | $5K | $0 | $5K | 6.55% |
| USI INSURANCE SERVICES LLC3 | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 12.28% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $274 | $274 | 0.67% |
| USI INSURANCE SERVICES LLC3 | 3440 WALNUT BOULEVARD BUILDING A, 2ND FLOOR FREMONT, CA 94538 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $679 | $0 | $679 | 10.73% |
| USI INSURANCE SERVICES LLC3 | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $144 | $0 | $144 | 2.35% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $99 | $99 | 1.62% |
| STEVE BAKER3 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $397 | $0 | $397 | 37.03% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PRE-PAID LEGAL SERVICES INC. DBA LEGAL SHIELD | $131 | $0 | $131 | 12.22% |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WESTERN HEALTH ADVANTAGE | 102 | $596K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 205 | $79K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 118 | $6K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $47K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $41K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $41K |
| Prescription drug | WESTERN HEALTH ADVANTAGE | 102 | $596K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 151 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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.