| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $50K | $0 | $50K | 3.49% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $3K | $0 | $3K | 4.00% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $8K | $0 | $8K | 8.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 3.41% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY IRVINE, CA 92618 | UDC DENTAL OF CALIFORNIA, INC. | $4K | $0 | $4K | 8.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | $0 | $4K | 8.39% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $34 | $2K | 9.78% |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $250 | $1K | 8.45% |
| DAVID A. RACKLIFFE3 | 28450 EVENING BREEZE DRIVE YORBALINDA, CA 92887 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $857 | $136 | $993 | 6.24% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $448 | $153 | $601 | 3.78% |
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 | 475 | 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) | 475 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 328 | $1.5M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 218 | $137K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 455 | $44K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 475 | $85K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 475 | $85K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 328 | $1.5M |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 475 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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.