| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | HEALTH NET | $17K | — | $17K | 3.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | HEALTH PLAN OF NEVADA | $3K | — | $3K | 3.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UNION SECURITY INSURANCE COMPANY | $4K | $944 | $5K | 8.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 29A TECHNOLOGY DRIVE, SUITE 100 IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $1K | — | $1K | 2.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21600 OXNARD STREET, 8TH FLOOR WOODLAND HILLS, CA 91367 | UNION SECURITY INSURANCE COMPANY | — | $228 | $228 | 0.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UDC DENTAL OF CALIFORNIA, INC | $2K | $300 | $2K | 9.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 288 | 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) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTH NET | 87 | $709K |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 240 | $78K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 268 | $14K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 240 | $56K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 240 | $56K |
| Prescription drug(3 contracts, 3 carriers) | HEALTH NET | 87 | $709K |
| Other | UNION SECURITY INSURANCE COMPANY | 240 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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.