| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $30K | $0 | $30K | 4.98% |
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $4K | 10.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203588 DALLAS, TX 75320 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $0 | $4K | 11.89% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $980 | $0 | $980 | 10.01% |
| INSURICA, INC.3 Filed as: INSURICA CA INS. SERVICES, INC. | 8500 STOCKDALE HIGHWAY, SUITE 200 BAKERSFIELD, CA 93311 | AMERICAN FIDELITY ASSURANCE COMPANY | $50 | $0 | $50 | 5.27% |
| TAWNY M BRADY3 Filed as: TAWNY M. BRADY | 1508 WAKEHURST COURT BAKERSFIELD, CA 93311 | AMERICAN FIDELITY ASSURANCE COMPANY | $42 | $0 | $42 | 4.43% |
| HEALTH FORUM3 Filed as: HEALTH FORUM AHA SOLUTIONS INC. | UNKNOWN CHICAGO, IL 60606 | AMERICAN FIDELITY ASSURANCE COMPANY | $13 | $0 | $13 | 1.37% |
| BRENDA S HAMILTON3 Filed as: BRENDA S. HAMILTON | 1854 FIR AVENUE, SUITE 101 FRESNO, CA 93720 | AMERICAN FIDELITY ASSURANCE COMPANY | $12 | $0 | $12 | 1.26% |
| TRACEY A. KEISER-FRAZIER Filed as: TRACEY A. KEISER FRAZIER | 8181 EAST KAISER BOULEVARD ANAHEIM HILLS, CA 92808 | AMERICAN FIDELITY ASSURANCE COMPANY | $3 | $0 | $3 | 0.32% |
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 | $599K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 95 | $43K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 108 | $10K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 225 | $37K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 225 | $37K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 225 | $37K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 102 | $599K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 225 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.