| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 629649 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $48K | $0 | $48K | 2.96% |
| USI INSURANCE SERVICES LLC3 | 29A TECHNOLOGY DRIVE, SUITE 100 IRVINE, CA 92618 | BLUE CROSS OF CALIFORNIA | $32K | $0 | $32K | 1.96% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 3.14% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 5.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $504 | $9K | 11.88% |
| BANKER BENEFITS3 | 1303 J STREET, SUITE 600 SACRAMENTO, CA 95814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $744 | $0 | $744 | 1.00% |
| EUGENE PEREZ3 Filed as: EUGENE R. PEREZ | 5 GRANDVIEW DRIVE PALM COAST, FL 32137 | AFLAC | $981 | $135 | $1K | 3.98% |
| MJ INSURANCE3 Filed as: NAZMI GJONBALAJ AND VARIOUS AGENTS | 24332 ANDREA STREET LAGUNA HILLS, CA 92656 | AFLAC | $675 | $6 | $681 | 2.43% |
| MIRIAM HUNGERFORD3 | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $369 | $27 | $396 | 1.41% |
| THUY N. PHAM3 Filed as: THUY PHAM | 600 CALLE BIENVENIDO SAN CLEMENTE, CA 92673 | AFLAC | $364 | $0 | $364 | 1.30% |
| ROBERT BRIAN SHERMAN3 Filed as: ROBERT SHERMAN | 2581 AMHERST AVENUE LOS ANGELES, CA 90064 | AFLAC | $324 | $27 | $351 | 1.25% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY DAY ASSOCIATES, LLC | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $177 | $0 | $177 | 0.63% |
| STRATEGIC LIFE INSURANCE3 Filed as: STRATEGIC LIFE INS. SERVICES, INC. | 1936 EAST DEERE AVENUE SANTA ANA, CA 92705 | AFLAC | $175 | $0 | $175 | 0.62% |
| TRACY BROUGHTON4 | 6 EDENDALE STREET LADERA RANCH, CA 92694 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $85 | $0 | $85 | 11.10% |
| SHELTER MINISTRIES, INC.4 Filed as: SHELTER MINISTRIES, INC., | 31441 SANTA MARGARITA PARKWAY SUITE A244 RANCHO SANTA MARGARITA, CA 92688 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $31 | $0 | $31 | 4.05% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 185 | $1.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $240K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $240K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $74K |
| Short-term disability | AFLAC | 31 | $28K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $74K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 185 | $1.9M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.