| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $95K | $7K | $102K | 0.71% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $99K | $0 | $99K | 0.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES INC | 6100 FAIRVIEW ROAD, SUTIE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $0 | $17K | $17K | 0.12% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | $34K | $0 | $34K | 3.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $13K | $16K | $30K | 2.65% |
| USI INSURANCE SERVICES LLC3 | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FORT LAUDERDALE, FL 33308 | HARTFORD LIFE AND ACCIDENT | $0 | $833 | $833 | 0.07% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $9K | $0 | $9K | 0.80% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 4211 WEST BOY SCOUT BOULEVARD SUITE 800 TAMPA, FL 33607 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $6K | $0 | $6K | 0.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OPTIMA HEALTH PLAN | $10K | $0 | $10K | 3.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OPTIMA HEALTH PLAN | $5K | $0 | $5K | 3.86% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS | 14715 NE 95TH STREET, SUITE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 11.25% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE IRVINE, CA 92618 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 3.75% |
| BURNHAM BENEFITS INSURANCE SERVICES4 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PRE PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $2K | $0 | $2K | 8.13% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $2K | $0 | $2K | 6.14% |
| USI INSURANCE SERVICES LLC4 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | PRE PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $1K | $0 | $1K | 4.03% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | $0 | $3K | $3K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 61007 VIRGINIA BEACH, VA 23466 | OHIC PPO | $182 | $0 | $182 | 1.60% |
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 | 1,340 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 2,450 | $16.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 2,450 | $14.4M |
| Vision | BLUE CROSS OF CALIFORNIA | 2,450 | $14.4M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,340 | $1.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,340 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,340 | $1.1M |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,450 | $15.9M |
| Other(8 contracts, 7 carriers) | BLUE CROSS OF CALIFORNIA | 2,450 | $16.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,450 | — |
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.