| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $129K | — | $129K | 4.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 6100 FAIRVIEW ROAD STE 1400 14TH FLOOR CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | — | $16K | $16K | 0.54% |
| USI INSURANCE SERVICES LLC3 | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 4.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 201 MISSION ST FL 11 SAN FRANCISCO, CA 94105 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $89 | $10K | 5.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4 | $4 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 3.80% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK RD CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $8K | 7.56% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $3K | — | $3K | 4.55% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BNFTS LLC | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 92123 | UNUM INSURANCE COMPANY | $8K | $292 | $8K | 23.75% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK RD CORDOVA, CA 95670 | UNUM INSURANCE COMPANY | $3K | $125 | $4K | 10.18% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK RD CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $467 | $3K | 12.00% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK RD CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $226 | $1K | 9.88% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $79 | — | $79 | 23.17% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | METLIFE LEGAL PLANS | $72 | — | $72 | 21.11% |
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 | 825 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 840 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 530 | $3.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 466 | $174K |
| Vision(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 611 | $3.1M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 825 | $37K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $100K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $100K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 42 | $422K |
| Other(4 contracts, 3 carriers) | UNUM INSURANCE COMPANY | 825 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 825 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.