| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $75K | $3K | $79K | 3.58% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | BLUE CROSS OF CALIFORNIA | $28K | $507 | $29K | 1.30% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $25K | $0 | $25K | 4.95% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 2.66% |
| JENNIFER MCDONALD3 | 86 EINDCHIME IRVINE, CA 92603 | AFLAC | $2K | $93 | $2K | 5.52% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM HUNGERFORD AND OTHER AGENTS | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $1K | $10 | $1K | 4.07% |
| DENISE M. AVILA WALKER3 Filed as: DENISE AVILA WALKER | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $660 | $64 | $724 | 2.24% |
| EUGENE PEREZ3 | 22 RIVERBEND DRIVE PALM COAST, FL 32137 | AFLAC | $599 | $38 | $637 | 1.97% |
| CATHERINE HERBERT3 | 5114 COSTA RUSTICO SAN CLEMENTE, CA 92673 | AFLAC | $328 | $142 | $470 | 1.45% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $401 | $65 | $466 | 1.44% |
| THUY N. PHAM3 Filed as: THUY PHAM | 600 CALLE BIENVENIDO SAN CLEMENTE, CA 92673 | AFLAC | $348 | $0 | $348 | 1.08% |
| BRIAN MILLER3 | 14 WALL STREET, 8TH FLOOR NEW YORK, NY 10005 | AFLAC | $341 | $0 | $341 | 5.82% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY DAY ASSOCIATES, LLC | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $260 | $0 | $260 | 4.43% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD L. LEE AND SONS, INC. | 31 PELL STREET NEW YORK, NY 10013 | AFLAC | $196 | $0 | $196 | 3.34% |
| PATRICK MARK BURNHAM3 Filed as: PATRICK BURNHAM | 854 WEST 181ST STREET APPARTMENT 4C NEW YORK, NY 10033 | AFLAC | $133 | $0 | $133 | 2.27% |
| PATRICK RUHLE3 Filed as: PATRICK HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $83 | $0 | $83 | 1.42% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORP., AND AGENTS | 401 FRANKLIN AVENUE, SUITE 312 GARDEN CITY, NY 11530 | AFLAC | $81 | $0 | $81 | 1.38% |
| TREVOR FENNELL3 | 11835 QUEENS BOULEVARD, SUITE 1403 FOREST HILLS, NY 11375 | AFLAC | $53 | $0 | $53 | 0.90% |
| JESSE RAMOS4 | 7331 SHELBY LANE, SUITE 26 RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $450 | $0 | $450 | 22.02% |
| SHELETER MINISTRIES, INC.4 | 430 COURFIELD DRIVE FRANKLIN, TN 37064 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $31 | $0 | $31 | 1.52% |
| TRACY BROUGHTON4 | 6 EDENDALE STREET LADERA RANCH, CA 92694 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $29 | $0 | $29 | 1.42% |
| USI INSURANCE SERVICES LLC4 | 2375 EAST CAMELBACK ROAD SUITE 250 PHOENIX, AZ 85016 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $12 | $0 | $12 | 0.59% |
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 | 237 | 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) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 258 | $2.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 232 | $330K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 232 | $330K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 258 | $2.2M |
| Short-term disability(2 contracts) | AFLAC | 37 | $38K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 258 | $2.2M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 258 | $2.7M |
| Other(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 258 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
No prospect flags tripped on this filing.