| 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 | $61K | $0 | $61K | 3.78% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $11K | $0 | $11K | 6.22% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | $0 | $3K | 5.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $951 | $0 | $951 | 2.06% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY IRVINE, CA 92618 | UDC DENTAL OF CALIFORNIA, INC. | $3K | $0 | $3K | 8.00% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $18 | $1K | 9.80% |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $654 | $41 | $695 | 4.72% |
| DAVID A. RACKLIFFE3 Filed as: DAVID A. RACHLIFFE | 300 HEROIT COURT SPRING HILL, TN 37174 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $307 | $11 | $318 | 2.16% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $254 | $25 | $279 | 1.90% |
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 | 456 | 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) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 331 | $1.6M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 490 | $221K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 482 | $46K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 490 | $195K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 19 | $15K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 490 | $181K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 331 | $1.6M |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 490 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.