| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 62949 VIRGINIA BEACH, VA 234662949 | KAISER FOUNDATION HEALTH PLAN INC | $44K | — | $44K | 3.73% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 1.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC - WEST | IRVINE OPCO P.O. BOX 62683 VIRGINIA BEACH, VA 234662683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 9.40% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $863 | — | $863 | 2.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHER CA INS SVCS INC. | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 913677578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $610 | — | $610 | 1.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 62949 ATTN WEST VIRGINIA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 7.57% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $852 | $852 | 3.33% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $421 | — | $421 | 1.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC - WEST | IRVINE OPCO P.O. BOX 62683 VIRGINIA BEACH, VA 234662683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $210 | $1K | 8.79% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $393 | — | $393 | 2.58% |
| CAMDEN INSURANCE AGENCY3 | 3255 WILSHIRE BOULEVARD, SUITE 1610 LOS ANGELES, CA 90010 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 16.37% |
| ENROLLEASE3 Filed as: ONE DIGITAL | 20 ENTERPRISE, SUITE 330 ALISO VIEJO, CA 92656 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $347 | — | $347 | 2.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC - WEST | IRVINE OPCO P.O. BOX 62683 VIRGINIA BEACH, VA 234662683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $594 | $142 | $736 | 9.30% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $198 | — | $198 | 2.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC - WEST | IRVINE OPCO P.O. BOX 62683 VIRGINIA BEACH, VA 234662683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $321 | $188 | $509 | 9.31% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $136 | — | $136 | 2.49% |
| USI INSURANCE SERVICES LLC3 Filed as: USI OF SOUTHERN CA INS SVCS INC. | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 913677578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $90 | — | $90 | 1.65% |
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 | 250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 209 | $1.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 179 | $26K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 168 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $41K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 74 | $23K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 209 | $1.2M |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.