| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 630 WEST GERMANTOWN PIKE, SUITE 200 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIANS SERVICE | $0 | $94K | $94K | 5.26% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $26K | $3K | $29K | 11.15% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $25 | $11K | 15.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $139 | $0 | $139 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2 | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $202 | $0 | $202 | 0.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 44.79% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $413 | $20 | $433 | 3.07% |
| TRACY BROUGHTON4 | 6 EDENDALE STREET LADERA RANCH, CA 92694 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $253 | $0 | $253 | 9.82% |
| BY HIS DESIGN, INC.4 | 430 COURFIELD DRIVE FRANKLIN, TN 37064 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $71 | $0 | $71 | 2.76% |
| BLAKE HENRY4 | 9 SUMMITCREST TRABUCO CANYON, CA 92679 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $31 | $0 | $31 | 1.20% |
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 | 191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 339 | $1.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $258K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 361 | $22K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $258K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $272K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $258K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 339 | $1.8M |
| Other(4 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $344K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 361 | — |
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.