| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21600 OXNARD STREET, 8TH FLOOR WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $76K | $58 | $76K | 3.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 630 GERMANTOWN PIKE, SUITE 200 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIANS SERVICE | $67K | — | $67K | 2.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $5K | 3.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $27 | $4K | 2.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.79% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT HESS AND COMPANY, INC. | 1120 MAR WEST, SUITE B TIBURON, CA 94920 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | — | $12K | 13.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | VISION SERVICE PLAN | $1K | — | $1K | 2.35% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET SEATTLE, WA 98101 | VISION SERVICE PLAN | $516 | — | $516 | 1.03% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | VISION SERVICE PLAN | $176 | — | $176 | 0.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | SAFEGUARD HEALTH PLAN, INC., A CALIFORNIA CORPORATION | $1K | — | $1K | 2.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3716 NORFOLK, VA 23514 | SAFEGUARD HEALTH PLAN, INC., A CALIFORNIA CORPORATION | $975 | — | $975 | 2.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLAN, INC., A CALIFORNIA CORPORATION | — | $326 | $326 | 0.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLAN, INC., A CALIFORNIA CORPORATION | — | $235 | $235 | 0.58% |
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 | 323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 507 | $2.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 367 | $205K |
| Vision | VISION SERVICE PLAN | 198 | $50K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 324 | $91K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 324 | $91K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 507 | $2.2M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 324 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.