| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $28K | $0 | $28K | 2.54% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM BC LIFE AND HEALTH INSURANCE | UNKNOWN RUTHERFORD, CA 94573 | BLUE CROSS OF CALIFORNIA | $0 | $11K | $11K | 0.97% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $0 | $6K | $6K | 0.53% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 2.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $411 | $411 | 0.09% |
| USI INSURANCE SERVICES LLC3 | 1039A NORTH MCDOWELL BOULEVARD 1ST FLOOR, SUITE A PETALUMA, CA 94954 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $727 | $13K | 12.93% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV. | 12647 ALCOSTA BOULEVARD, SUITE 330 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 2.59% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, SUITE 1100 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $349 | $349 | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 GUTHRIE LANE, SUITE 22 BRENTWOOD, CA 94513 | ZURICH AMERICAN INSURANCE COMPANY | $150 | $0 | $150 | 15.00% |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 138 | $1.5M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $97K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $97K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $97K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 138 | $1.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.