| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $140K | $983 | $141K | 5.54% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $0 | $687 | $687 | 0.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $31K | $12K | $44K | 6.94% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $12K | $21K | 6.07% |
| DENISE M. AVILA WALKER3 | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $2K | $38 | $2K | 4.13% |
| JAIMIE ANNE DUNTON AND OTHER AGENTS3 | 25201 PASEO DE ALICIA, UNIT 190 LAGUNA HILLS, CA 92653 | AFLAC | $1K | $32 | $1K | 3.33% |
| JENNIFER MCDONALD3 Filed as: JENNIFER MC DONALD | 15201 DANA IRVINE, CA 92618 | AFLAC | $373 | $133 | $506 | 1.25% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $447 | $38 | $485 | 1.20% |
| EUGENE PEREZ3 Filed as: EUGENE R. PEREZ | 22 RIVERBEND DRIVE PALM COAST, FL 32137 | AFLAC | $475 | $0 | $475 | 1.17% |
| THUY N. PHAM3 | 600 CALLE BIENVENIDO SAN CLEMENTE, CA 92673 | AFLAC | $354 | $0 | $354 | 0.87% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $254 | $0 | $254 | 0.63% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY DAY ASSOCIATES, LLC | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $189 | $0 | $189 | 3.83% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD L. LEE AND SONS, INC. | 31 PELL STREET NEW YORK, NY 10013 | AFLAC | $175 | $0 | $175 | 3.54% |
| BRIAN MILLER3 | 52 COURT STREET FREEHOLD, NJ 07728 | AFLAC | $101 | $0 | $101 | 2.05% |
| TREVOR FENNELL3 | 7 HIGHLAND LANE EAST HAMPTON, NY 11937 | AFLAC | $48 | $0 | $48 | 0.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: KEVIN G. GALLAGHER AND OTHER AGENTS | 2640 LAKE SHORE DRIVE, UNIT 411 RIVIERA BEACH, FL 33404 | AFLAC | $32 | $0 | $32 | 0.65% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $31 | $0 | $31 | 0.63% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORP | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $28 | $0 | $28 | 0.57% |
| JESSE RAMOS4 | 7331 SHELBY LANE, SUITE 26 RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $319 | $0 | $319 | 13.58% |
| BY HIS DESIGN, INC.4 | 430 COURFIELD DRIVE FRANKLIN, TN 37064 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $33 | $0 | $33 | 1.40% |
| TRACY BROUGHTON4 | 6 EDENDALE STREET LADERA RANCH, CA 92694 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $32 | $0 | $32 | 1.36% |
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 | 247 | 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) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 405 | $3.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 247 | $345K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 247 | $345K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 405 | $2.5M |
| Short-term disability(2 contracts) | AFLAC | 40 | $45K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 405 | $2.5M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 405 | $3.2M |
| Other(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 405 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 405 | — |
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.