| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIANS SERVICE | $0 | $4K | $4K | 0.09% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $9K | $9K | 0.94% |
| USI INSURANCE SERVICES LLC3 | 10 SOUTH WACKER DRIVE, 17TH FLOOR CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $4K | $4K | 0.42% |
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 | 252 | 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) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 603 | $4.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 638 | $394K |
| Vision | VISION SERVICE PLAN | 207 | $35K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 251 | $976K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 251 | $976K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 251 | $976K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 603 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 638 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.