| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $5K | 0.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $12K | $1K | $13K | 11.97% |
| BUSINESSOLVER.COM, INC.3 | 1025 WASHWORTH ROAD WEST DES MOINES, IA 50265 | METLIFE LEGAL PLANS | $0 | $2K | $2K | 1.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 5.29% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | $0 | $1K | 2.80% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $0 | $589 | $589 | 3.35% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD FIRE INSURANCE COMPANY | $318 | $286 | $604 | 28.52% |
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 | 862 | 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) | 862 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 33 | $45K |
| Dental | AETNA LIFE INSURANCE COMPANY | 119 | $18K |
| Vision | VISION SERVICE PLAN | 302 | $43K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 955 | $785K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 955 | $785K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 955 | $785K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 33 | $45K |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 955 | $981K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 955 | — |
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.