| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 S FL 12 SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $75K | $0 | $75K | 2.77% |
| MEGAN INSURANCE SERVICES3 Filed as: MEGAN INSURANCE SERVICES, INC. | 30053 QUAIL RUN DR AGOURA HILLS, CA 91301 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 0.31% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | $44K | — | $44K | 2.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | $36K | — | $36K | 1.85% |
| MEGAN INSURANCE SERVICES3 Filed as: MEGAN INSURANCE SERVICES INC | 30053 QUAIL RUN DR AGOURA HILLS, CA 91301 | AETNA LIFE INSURANCE COMPANY | $7K | — | $7K | 0.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 580 N 4TH STREET SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | $4K | $23K | 3.67% |
| MEGAN INSURANCE SERVICES3 Filed as: MEGAN INSURANCE SERVICES INC | 30053 QUAIL RUN DR AGOURA HILLS, CA 91301 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16 | $0 | $16 | 0.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS, MN 55426 | AETNA HEALTH, INC. | $14K | $0 | $14K | 2.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA HEALTH, INC. | $11K | $0 | $11K | 1.84% |
| MEGAN INSURANCE SERVICES3 Filed as: MEGAN INSURANCE SERVICES INC | 30053 QUAIL RUN DR AGOURA HILLS, CA 24890 | AETNA HEALTH, INC. | $2K | $0 | $2K | 0.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P.O. BOX 203014 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $15K | $4K | $19K | 4.27% |
| MEGAN INSURANCE SERVICES3 Filed as: MEGAN INSURANCE SERVICES, INC | 30053 QUAIL RUN DR AGOURA HILLS, CA 91301 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $1K | $0 | $1K | 0.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 90 S CASCADE AVE 2ND FLOOR COLORADO SPRINGS, CO 80903 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $5K | $69 | $5K | 4.42% |
| USI INSURANCE SERVICES LLC3 | WORLD TRADE CENTER MAIN STREET, SUITE 900 NORFOLK, VA 23510 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $897 | $0 | $897 | 0.87% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 580 N. 4TH STREET SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $313 | $2K | 16.35% |
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 | 1,074 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,082 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 566 | $5.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,074 | $630K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,074 | $630K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,074 | $630K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,074 | $630K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,074 | $630K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 566 | $3.3M |
| Other(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,074 | $641K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,074 | — |
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.