| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL, INC. | 600 HIGHWAY 169 S 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $48K | — | $48K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL, INC | 600 HIGHWAY 169 S 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $33K | — | $33K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES NATIONAL INC | 213 S JEFFERSON ST SW ROANOKE, VA 24011 | HEALTHKEEPERS, INC. | $8K | — | $8K | 1.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 6100 FAIRVIEW RD 10TH FLOOR CHARLOTTE, NC 28222 | HARTFORD LIFE AND ACCIDENT | $18K | — | $18K | 9.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 1.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 5200 N PALM AVE SUITE 114 FRESNO, CA 937042225 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $333 | $333 | 1.39% |
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 | 426 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 563 | $4.2M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 423 | $24K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 489 | $178K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 489 | $178K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 489 | $178K |
| Other | HARTFORD LIFE AND ACCIDENT | 489 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 563 | — |
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.