| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $140K | $0 | $140K | 2.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $450 | $450 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 DUBLIN, OH 43017 | ANTHEM LIFE INSURANCE COMPANY | $188K | $0 | $188K | 8.64% |
| BENE RE LLC3 Filed as: BENE RE, LLC | 5217 MONROE STREET, SUITE B TOLEDO, OH 43623 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $47K | $47K | 8.00% |
| WORKPLACE SOLUTIONS, INC.3 | 120A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | RELIASTAR LIFE INSURANCE COMPANY | $35K | $0 | $35K | 6.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | RELIASTAR LIFE INSURANCE COMPANY | $24K | $0 | $24K | 4.00% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $10K | $10K | 1.62% |
| USI INSURANCE SERVICES LLC3 | 333 SOUTH GRAND AVENUE LOS ANGELES, CA 90071 | SIMNSA | $23K | $0 | $23K | 7.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $21K | $5K | $26K | 13.95% |
| WPS ASSOCIATES, INC.3 | 120 GILLS CREEK PARKWAY COLUMBIA, SC 29209 | BLUE CROSS OF CALIFORNIA | $6K | $0 | $6K | 3.08% |
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 | 3,543 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 62 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,612 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 872 | $5.0M |
| Dental | SIMNSA | 99 | $329K |
| Vision | BLUE CROSS OF CALIFORNIA | 3,455 | $185K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 3,532 | $2.2M |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 3,532 | $2.2M |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 3,532 | $2.2M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 872 | $5.0M |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 3,532 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,532 | — |
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.