| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 11350 MCCORMICK ROAD EXECUTIVE PLAZA III, SUITE 120 HUNT VALLEY, MD 21031 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | — | $4K | $4K | 0.28% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE 5TH FLOOR NEW YORK, NY 10016 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | — | $886 | $886 | 2.60% |
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 | 332 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | AETNA LIFE INSURANCE CO. | 875 | $3.2M |
| Dental | AETNA LIFE INSURANCE CO. | 875 | $1.7M |
| Vision | AETNA LIFE INSURANCE CO. | 875 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 875 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.