| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 213 SOUTH JEFFERSON STREET SW ROANOKE, VA 24011 | BLUE CROSS OF CALIFORNIA | $31K | $14K | $45K | 7.09% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $29K | $0 | $29K | 4.69% |
| GALLAGHER BENEFIT SERVICES, INC. | 160 GUTHRIE LANE, SUITE 22 BRENTWOOD, CA 94513 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $11K | $0 | $11K | 1.73% |
| ANTHONY JOSEPH PROCACCINI3 Filed as: ANTHONY PROCACCINI | 67328 ZUNI COURT CATHEDRAL CITY, CA 92234 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 0.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $17K | $3 | $17K | 4.31% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, SUITE 1100 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $470 | $6K | 8.88% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT, SUITE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $78 | $2K | 2.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $750 | $0 | $750 | 7.65% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, SUITE 1100 SAN FRANCISCO, CA 94105 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $222 | $0 | $222 | 14.99% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 61 | $1.7M |
| Dental | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 60 | $615K |
| Vision | VISION SERVICE PLAN | 63 | $10K |
| Life insurance(2 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 88 | $688K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 88 | $73K |
| Long-term disability(2 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 88 | $688K |
| Prescription drug(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 61 | $1.1M |
| Other(4 contracts, 4 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 800 | $689K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 800 | — |
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.