| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES, INC. | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | KAISER FOUNDATION HEALTH PLAN INC | $39K | — | $39K | 1.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 201629 DALLAS, TX 753201629 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $70K | — | $70K | 13.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $15K | — | $15K | 2.89% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | — | $17K | 3.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 201629 DALLAS, TX 753201629 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 2.30% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | — | $17K | 3.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 201629 DALLAS, TX 753201629 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | — | $10K | 2.30% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES, INC. | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 1.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 201629 DALLAS, TX 753201629 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $29K | — | $29K | 8.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | -$3K | — | -$3K | -0.87% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE | $8K | — | $8K | 3.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL,INC | P.O. BOX 201629 DALLAS, TX 753201629 | FIDELITY SECURITY LIFE INSURANCE | $332 | — | $332 | 0.15% |
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 | 2,864 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 425 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 339 | $2.5M |
| Vision | FIDELITY SECURITY LIFE INSURANCE | 4,360 | $223K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,092 | $862K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,639 | $447K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,668 | $469K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 339 | $2.5M |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,092 | $862K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,360 | — |
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.