| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1600 BROADWAY, 9TH FLOOR DENVER, CO 80202 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | $0 | $4K | 0.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $24K | $42K | 10.37% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | $0 | $22K | 5.47% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $13K | $0 | $13K | 3.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2375 EAST CAMELBACK ROAD, SUITE 250 PHOENIX, AZ 85016 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $2K | $11K | 2.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $18K | $0 | $18K | 14.97% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.96% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$82 | $0 | -$82 | -0.07% |
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 | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 74 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 485 | $401K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 485 | $401K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 767 | $407K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 767 | $407K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 767 | $407K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 74 | $2.0M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 767 | $527K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 767 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.