| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $44K | $0 | $44K | 3.61% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS, ALLEN AND HALL, INC. | 115 OFFICE PARK DRIVE BIRMINGHAM, AL 35223 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 1.28% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 4.22% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS, ALLEN AND HALL, INC. | 115 OFFICE PARK DRIVE BIRMINGHAM, AL 35223 | METROPOLITAN LIFE INSURANCE COMPANY | $421 | $0 | $421 | 0.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 N GLENOAKS BOULEVARD, SUITE 410 BURBANK, CA 91502 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $25 | $25 | 0.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.87% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS, ALLEN AND HALL, INC. | 115 OFFICE PARK DRIVE, SUITE 200 BIRMINGHAM, AL 35223 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.13% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3 PARKWAY NORTH, SUITE 500 DEERFIELD, IL 60015 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $976 | $0 | $976 | 2.36% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $28 | $28 | 0.07% |
| BRANDON TYLOR-DA SHIRLEY3 | 5110 SOUTH SHERBOURNE DRIVE LOS ANGELES, CA 90056 | AFLAC | $2K | $14 | $2K | 8.77% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 2000 WOODLAND HILLS, CA 91367 | AFLAC | $2K | $0 | $2K | 5.66% |
| MYKISHA L. THOMAS3 Filed as: MYKISHA L. BUTLER | 3886 3RD AVENUE LOS ANGELES, CA 90008 | AFLAC | $726 | $0 | $726 | 2.60% |
| DAVID HERNANDEZ3 | 2239 WEST 190TH STREET TORRANCE, CA 90504 | AFLAC | $691 | $7 | $698 | 2.50% |
| CARLOS DAVID HERNANDEZ3 Filed as: CARLOS JESUS LOPEZ | 14025 JEFFERSON AVENUE HAWTHORNE, CA 90250 | AFLAC | $219 | $0 | $219 | 0.79% |
| TALHA ZAQUIR RAHMAN3 Filed as: TALHA ZAQUIR RAHMAN & OTHER AGENTS | 10973 PRESCOTT DRIVE FRISCO, TX 75033 | AFLAC | $175 | $0 | $175 | 0.63% |
| SARAH ELLIN EDWARDS3 | 5211 PACIFIC CONCOURSE DRIVE APARTMENT 1254 LOS ANGELES, CA 90045 | AFLAC | $113 | $7 | $120 | 0.43% |
| USI INSURANCE SERVICES LLC3 | 333 SOUTH GRAND AVENUE, SUITE 1450 LOS ANGELES, CA 90071 | HUMANA INSURANCE COMPANY | $782 | $0 | $782 | 6.81% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS, ALLEN AND HALL, INC. | 115 OFFICE PARK DRIVE, SUITE 200 BIRMINGHAM, AL 35223 | HUMANA INSURANCE COMPANY | $346 | $0 | $346 | 3.01% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | HUMANA INSURANCE COMPANY | $0 | $179 | $179 | 1.56% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 153 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 179 | $99K |
| Vision | HUMANA INSURANCE COMPANY | 103 | $11K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 129 | $41K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 129 | $69K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 129 | $41K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 153 | $1.2M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 129 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.