| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA HEALTH OF CALIFORNIA, INC. | $77K | $5K | $82K | 4.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $46K | $0 | $46K | 2.70% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $23K | $134 | $23K | 4.01% |
| USI INSURANCE SERVICES LLC3 | 150 SOUTH 5TH STREET RYAN SUITE 2500 MINNEAPOLIS, MN 55402 | PREMIER ACCESS INSURANCE COMPANY | $9K | $0 | $9K | 4.99% |
| USI INSURANCE SERVICES LLC3 | 5901 PRIESTLY DRIVE, SUITE 306 CARLSBAD, CA 92008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $6K | $6K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.51% |
| JB CREATIVE SOLUTIONS LLC3 Filed as: JB CREATIVE SOLUTIONS, LLC | 3881 FREEMAN WAY PROSPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $513 | $21 | $534 | 4.84% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 103 PALM DRIVE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $494 | $24 | $518 | 4.70% |
| DAVID A. RACKLIFFE3 | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $336 | $11 | $347 | 3.15% |
| MICHAEL JAMES LANCASTER3 | 22365 EL TORO ROAD LAKE FOREST, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| MIKE MCCORMICK3 | 7 MONSERRAT PLACE FOOTHILL RANCH, CA 92610 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 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 | $224 | $1K | 18.22% |
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 | 309 | 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) | 309 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 264 | $4.2M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 477 | $180K |
| Vision | VISION SERVICE PLAN | 253 | $32K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 309 | $128K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 309 | $128K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 309 | $128K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 264 | $4.2M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 309 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 477 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.