| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $184K | $13K | $197K | 6.11% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $0 | $5K | $5K | 0.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $31K | $0 | $31K | 5.62% |
| NAZMI J. GJONBALAJ3 Filed as: NAZMI J. GJONBALAJ AND OTHER AGENTS | 24332 ANDREA STREET LAGUNA HILLS, CA 92656 | AFLAC | $696 | $0 | $696 | 2.64% |
| DENISE M. AVILA WALKER3 | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $610 | $0 | $610 | 2.31% |
| EUGENE PEREZ3 Filed as: EUGENE R. PEREZ | 22 RIVERBEND DRIVE PALM COAST, FL 32137 | AFLAC | $388 | $0 | $388 | 1.47% |
| THUY N. PHAM3 | 600 CALLE BIENVENIDO SAN CLEMENTE, CA 92673 | AFLAC | $324 | $0 | $324 | 1.23% |
| JENNIFER MCDONALD3 | 361 SHADOW OAKS IRVINE, CA 92618 | AFLAC | $314 | $0 | $314 | 1.19% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $220 | $0 | $220 | 0.83% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $201 | $0 | $201 | 0.76% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY M. DAY | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $73 | $0 | $73 | 1.60% |
| CHRISTY DAY ASSOCIATES LLC3 Filed as: CHRISTY M DAY | 199 WATER STREET, 23RD FLOOR NEW YORK, NY 10038 | AFLAC | $73 | $0 | $73 | 1.60% |
| BRIAN MILLER3 | 52 COURT STREET FREEHOLD, NJ 07728 | AFLAC | $62 | $0 | $62 | 1.36% |
| DENISE M. AVILA WALKER3 Filed as: DENISE MARIE AVILA-WALKER | 2605 ADELITA DRIVE HACIENDA HEIGHTS, CA 91745 | AFLAC | $50 | $0 | $50 | 1.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: KEVIN G. GALLAGHER AND OTHER AGENTS | 2640 LAKE SHORE DRIVE, UNIT 411 RIVIERA BEACH, FL 33404 | AFLAC | $45 | $0 | $45 | 0.99% |
| TREVOR FENNELL3 | 7 HIGHLAND LANE EAST HAMPTON, NY 11937 | AFLAC | $42 | $0 | $42 | 0.92% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORPORATION | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $24 | $0 | $24 | 0.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $221 | $21 | $242 | 9.69% |
| JESSE RAMOS4 | 7331 SHELBY PLACE, APARTMENT 20 RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $31 | $0 | $31 | 7.52% |
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 | 293 | 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) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 293 | $3.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 293 | $3.2M |
| Vision | BLUE CROSS OF CALIFORNIA | 293 | $3.2M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 293 | $3.2M |
| Short-term disability(2 contracts) | AFLAC | 26 | $31K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 293 | $3.2M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 293 | $3.8M |
| Other(5 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 293 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.