| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA HEALTH, INC. | $45K | — | $45K | 2.51% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL STREET BOSTON, MA 02110 | AETNA HEALTH, INC. | $17K | — | $17K | 0.95% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC. | $51K | — | $51K | 3.49% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2270 DOUGLAS BLVD, STE 220 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN INC. | $29K | — | $29K | 1.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE COMPANY | $34K | $1K | $35K | 2.74% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET BOSTON, MA 02110 | AETNA LIFE INSURANCE COMPANY | $12K | — | $12K | 0.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 7.19% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL STREET - 2ND FLOOR BOSTON, MA 02110 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.60% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $46 | $46 | 0.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | — | $1K | 3.29% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST - 4TH FLOOR BOSTON, MA 02110 | VISION SERVICE PLAN | $849 | — | $849 | 2.74% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 88 | $4.5M |
| Vision | VISION SERVICE PLAN | 230 | $31K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 196 | $101K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 196 | $101K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 88 | $4.5M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 196 | $101K |
| 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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.