| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH, FLOOR 12 SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC. | $85K | — | $85K | 2.98% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA LIFE INSURANCE CO. | $36K | — | $36K | 1.49% |
| USI INSURANCE SERVICES LLC3 | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $18K | $174 | $19K | 0.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $18K | $174 | $18K | 0.74% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA HEALTH, INC. | $12K | — | $12K | 1.50% |
| USI INSURANCE SERVICES LLC3 | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA HEALTH, INC. | $6K | — | $6K | 0.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA HEALTH, INC. | $5K | — | $5K | 0.69% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 1.51% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 1.49% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 203014 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $9K | $1K | $11K | 3.04% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $4K | — | $4K | 1.25% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 61007 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $2K | $19 | $2K | 2.05% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $2K | $28 | $2K | 1.69% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $1K | $3K | 2.84% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD., 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $956 | $2K | 2.66% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $2K | — | $2K | 5.05% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $666 | — | $666 | 1.44% |
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 | 1,173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 582 | $6.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,173 | $542K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 985 | $46K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,173 | $542K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 308 | $90K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 308 | $90K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 582 | $3.3M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,173 | $542K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,173 | — |
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."
No prospect flags tripped on this filing.