| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 600 HIGHWAY 169 SOUTH FLOOR 12 ST LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | $0 | $28K | 4.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 580 NORTH 4TH STREET SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 5.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 203588 DALLAS, TX 75320 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $0 | $4K | 12.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE | $982 | $0 | $982 | 8.95% |
| TAWNY M BRADY3 | 1508 WAKEHURST COURT BAKERSFIELD, CA 93311 | AMERICAN FIDELITY ASSURANCE COMPANY | $69 | $0 | $69 | 5.16% |
| INSURICA, INC.3 Filed as: INSURICA CA INSURANCE | 8500 STOCKDALE HIGHWAY SUITE 200 BAKERSFIELD, CA 93311 | AMERICAN FIDELITY ASSURANCE COMPANY | $57 | $0 | $57 | 4.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | AMERICAN FIDELITY ASSURANCE COMPANY | $31 | $0 | $31 | 2.32% |
| BRENDA S HAMILTON3 | 1854 EAST FIR AVENUE SUITE 101 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $25 | $0 | $25 | 1.87% |
| HEALTH FORUM3 | AHA SOLUTIONS INC CHICAGO, IL 60606 | AMERICAN FIDELITY ASSURANCE COMPANY | $15 | $0 | $15 | 1.12% |
| TRACEY A. KEISER-FRAZIER3 Filed as: TRACEY A KEISER FRAZIER | 8181 EAST KAISER BOULEVARD ANAHEIM HILLS, CA 92808 | AMERICAN FIDELITY ASSURANCE COMPANY | $6 | $0 | $6 | 0.45% |
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 102 | $605K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 94 | $45K |
| Vision | EYEMED VISION CARE | 114 | $11K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 230 | $32K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 230 | $32K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 230 | $32K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 102 | $605K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 230 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.
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.