| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1383 N MCDOWELL BLVD SUITE 170 PETALUMA, CA 94954 | SUTTER HEALTH PLAN | $14K | — | $14K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 150 N MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 4.07% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE SUITE 250 IRVINE, CA 92618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $6K | $10K | 15.09% |
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 | 105 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 62 | $521K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $66K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $66K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $66K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 62 | $521K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.