| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN FOUNTAIN VALLEY, CA 92708 | AETNA LIFE INSURANCE COMPANY | $69K | $9K | $78K | 3.62% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $17K | $0 | $17K | 0.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $35K | $2K | $37K | 2.86% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | PREMIER ACCESS INSURANCE COMPANY | $8K | $0 | $8K | 5.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $25K | $0 | $25K | 19.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 2.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | -$12K | $0 | -$12K | -9.08% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | VISION SERVICE PLAN | $840 | $0 | $840 | 2.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $584 | $0 | $584 | 1.90% |
| BRIAN YERVANT AKIAN3 | PO BOX 17269 IRVINE, CA 92623 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $466 | $5 | $471 | 3.47% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY, III | 9301 NW 33RD STREET DORAL, FL 33172 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $433 | $25 | $458 | 3.38% |
| DAVID A. RACKLIFFE3 | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $254 | $0 | $254 | 1.87% |
| MICHAEL JAMES LANCASTER3 | 22365 EL TORO ROAD LAKE FOREST, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| MIKE MCCORMICK3 | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | FEDERAL INSURANCE COMPANY | $1K | $168 | $1K | 17.51% |
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 | 304 | 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) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 286 | $3.5M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 483 | $160K |
| Vision | VISION SERVICE PLAN | 257 | $31K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 304 | $132K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 304 | $132K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 304 | $132K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 286 | $3.5M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 304 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 483 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.