| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $20K | $0 | $20K | 4.91% |
| LUMITY, INC.3 | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN INC | $45 | $0 | $45 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 1039-A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | DELTA DENTAL OF CALIFORNIA | $30K | $0 | $30K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $206 | $13K | 10.16% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD SAN FRANCISCO, CA 94131 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $8K | $8K | 5.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $264 | $264 | 0.20% |
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 58 | $410K |
| Dental | DELTA DENTAL OF CALIFORNIA | 471 | $302K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $129K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $129K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $129K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 58 | $410K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 179 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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.