| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $156K | $1K | $158K | 5.11% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $0 | $3K | $3K | 0.09% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $36K | $0 | $36K | 4.96% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $14K | $22K | 7.50% |
| DENISE M. AVILA WALKER3 Filed as: DENISE M. WALKER | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $1K | $20 | $1K | 3.62% |
| MJ INSURANCE3 Filed as: NAZMI GJONBALAJ AND VARIOUS AGENTS | 24332 ANDREA STREET LAGUNA HILLS, CA 92656 | AFLAC | $1K | $0 | $1K | 2.97% |
| JENNIFER MCDONALD3 | 15201 DANA IRVINE, CA 92618 | AFLAC | $444 | $0 | $444 | 1.24% |
| EUGENE PEREZ3 Filed as: EUGENE R. PEREZ | 22 RIVERBEND DRIVE PALM COAST, FL 32137 | AFLAC | $418 | $0 | $418 | 1.17% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $340 | $5 | $345 | 0.96% |
| THUY N. PHAM3 | 600 CALLE BIENVENIDO SAN CLEMENTE, CA 92673 | AFLAC | $320 | $0 | $320 | 0.89% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $227 | $0 | $227 | 0.63% |
| DENISE M. AVILA WALKER3 Filed as: DENISE M. WALKER | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $176 | $0 | $176 | 3.44% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY DAY AND ASSOCIATES LLC | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $169 | $0 | $169 | 3.30% |
| HAROLD L LEE & SONS INC3 Filed as: HAROLD LEE & SONS INC | 31 PELL STREET NEW YORK, NY 10013 | AFLAC | $153 | $0 | $153 | 2.99% |
| BRIAN MILLER3 | 52 COURT STREET FREEHOLD, NJ 07728 | AFLAC | $91 | $0 | $91 | 1.78% |
| KENNETH C MEIER CORP3 Filed as: KENNETH MEIER CORP AND OTHER AGENTS | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $55 | $0 | $55 | 1.07% |
| TREVOR FENNELL3 | 7 HIGHLAND LANE EAST HAMPTON, NY 11937 | AFLAC | $42 | $0 | $42 | 0.82% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $28 | $0 | $28 | 0.55% |
| JESSE RAMOS4 | 7331 SHELBY LANE RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $393 | $0 | $393 | 13.33% |
| BY HIS DESIGN, INC.4 Filed as: BY HIS DESIGN, INC | 430 COURFIELD DRIVE FRANKLIN, TN 37064 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $28 | $0 | $28 | 0.95% |
| TRACY BROUGHTON4 | 6 EDENDALE STREET LADERA RANCH, CA 92694 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $27 | $0 | $27 | 0.92% |
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 | 252 | 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) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 292 | $3.8M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 292 | $3.4M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 292 | $3.4M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 292 | $3.1M |
| Short-term disability(2 contracts) | AFLAC | 34 | $41K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 292 | $3.1M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 292 | $3.8M |
| Other(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 292 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.