| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 630 WEST GERMANTOWN PIKE, SUITE 20 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIANS SERVICE | $8K | $46K | $54K | 6.51% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 2000 WOODLAND HILLS, CA 91367 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | $0 | $2K | 2.62% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | $0 | $2K | 2.23% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $563 | $0 | $563 | 0.64% |
| USI INSURANCE SERVICES LLC3 | 4370 LA JOLLA VILLAGE DRIVE SAN DIEGO, CA 92112 | MEDIEXCEL HEALTH PLAN | $2K | $0 | $2K | 7.51% |
| USI INSURANCE SERVICES LLC3 | 2800 WEST MARCH LANE, SUITE 100 STOCKTON, CA 95219 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.08% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $438 | $438 | 6.39% |
| USI INSURANCE SERVICES LLC3 | 630 WEST GERMANTOWN PIKE, SUITE 20 PLYMOUTH MEETING, PA 19462 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $110 | $0 | $110 | 3.28% |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 157 | $859K |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 157 | $832K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 157 | $832K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 173 | $10K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 44 | $88K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 44 | $88K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 157 | $859K |
| Other(3 contracts, 3 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 173 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.