| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $43K | — | $43K | 3.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA HEALTH OF CALIFORNIA, INC. | $7K | — | $7K | 3.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62683 VIRGINIA BEACH, VA 23467 | AETNA HEALTH OF CALIFORNIA, INC. | $3K | — | $3K | 1.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $9K | — | $9K | 6.31% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UNION SECURITY INSURANCE COMPANY | — | $3K | $3K | 2.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $3K | — | $3K | 7.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | UDC DENTAL OF CALIFORNIA, INC. | $3K | — | $3K | 8.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UDC DENTAL OF CALIFORNIA, INC. | — | $652 | $652 | 1.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2021 WEST MARCH LANE STOCKTON, CA 95207 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $42 | $1K | 10.53% |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $879 | $316 | $1K | 8.46% |
| DAVID A. RACKLIFFE3 | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $728 | $55 | $783 | 5.54% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $439 | $169 | $608 | 4.30% |
| ERIC TERRAZAS3 | 2101 IPSEN WAY PLACENTIA, CA 92870 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 NE 3RD AVENUE, SUITE 610 FORT LAUDERDALE, FL 23467 | AETNA LIFE INSURANCE COMPANY | — | $92 | $92 | 4.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62683 VIRGINIA BEACH, VA 23467 | AETNA LIFE INSURANCE COMPANY | $86 | — | $86 | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | -$127 | — | -$127 | -5.91% |
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 | 370 | 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) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 319 | $1.5M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 370 | $179K |
| Vision | BLUE CROSS OF CALIFORNIA | 457 | $44K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 370 | $137K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 370 | $137K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 319 | $1.5M |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 370 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 457 | — |
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.