| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $81K | $1K | $83K | 5.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | $0 | $14K | 5.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | DELTA DENTAL OF CALIFORNIA | $6K | — | $6K | 6.88% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $5K | $847 | $6K | 11.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $0 | $14 | $14 | 0.03% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 102159 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | $0 | $1 | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | — | $2K | 10.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $455 | $3K | 29.67% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $265 | $42 | $307 | 11.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, AZ 91203 | METLIFE LEGAL PLANS | -$74 | — | -$74 | -2.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COMBINED INSURANCE | $299 | — | $299 | 24.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN MARINA DEL REY, CA 90292 | COMBINED INSURANCE | $8 | — | $8 | 0.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN GENERAL INSURANCE COMPANY | $103 | $13 | $116 | 16.25% |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 191 | $1.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 197 | $88K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 191 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 170 | $49K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 170 | $48K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 170 | $48K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 191 | $1.9M |
| Other(5 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 170 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.