| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | AETNA LIFE INSURANCE COMPANY | $160K | $17K | $177K | 7.21% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | AETNA HEALTH OF CALIFORNIA INC. | $104K | $0 | $104K | 6.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES WEST | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $30K | $13K | $43K | 21.71% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 4.06% |
| PLANSOURCE BENEFITS ADMINISTRATION5 Filed as: PLANSOURCE BENEFIT ADMIN INC. | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 2.80% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $6K | $0 | $6K | 10.80% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $5K | $0 | $5K | 9.52% |
| JOHNSON RESOURCES3 | 7373 EAST DOUBLETREE RANCH SUITE 200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 2.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | PO BOX 9004 VAN NUYS, CA 91409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $932 | $0 | $932 | 4.88% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $367 | $0 | $367 | 1.92% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN INC. | PO BOX 1313 ORLANDO, FL 32802 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $95 | $0 | $95 | 0.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $0 | $88 | 0.46% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $5 | $38 | 0.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | PO BOX 9004 VAN NUYS, CA 91409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 6.15% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS INC | 14715 NE 95TH STREET, SUITE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $858 | $0 | $858 | 5.01% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $477 | $10 | $487 | 2.85% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $60 | $0 | $60 | 0.35% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN INC. | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42 | $0 | $42 | 0.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21 | $0 | $21 | 0.12% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $1K | $0 | $1K | 14.16% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $39 | $0 | $39 | 0.41% |
| DOMINIC A. NACCHIA4 Filed as: DOMINIC A NACCHIA | 201 CAROLINA POINT PARKWAY SUITE 206 GREENVILLE, SC 29607 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $22 | $0 | $22 | 0.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | FIRST UNUM LIFE INSURANCE COMPANY | $5 | $0 | $5 | 1.89% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN INC. | PO BOX 1313 ORLANDO, FL 32802 | FIRST UNUM LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.38% |
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 | 420 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 322 | $4.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 322 | $2.5M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 502 | $53K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 420 | $199K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 44 | $19K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 420 | $199K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 322 | $4.0M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 420 | $225K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 502 | — |
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.