| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $22K | $719 | $22K | 1.29% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGUEROA STREET SUITE 2100 LOS ANGELES, CA 90017 | DELTA DENTAL OF CALIFORNIA | $20K | $0 | $20K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $269 | $0 | $269 | 0.70% |
| EILENE ROTHMAN3 | 2180 WESTWOOD BOULEVARD, SUITE 2B LOS ANGELES, CA 90025 | HARTFORD LIFE AND ACCIDENT | $498 | $0 | $498 | 11.86% |
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 | 171 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 161 | $1.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 166 | $198K |
| Vision | VISION SERVICE PLAN | 142 | $38K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 167 | $4K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 161 | $1.7M |
| Other | HARTFORD LIFE AND ACCIDENT | 167 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.