| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC | $40K | $0 | $40K | 4.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC | $0 | $45 | $45 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC | $0 | $44 | $44 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | DELTA DENTAL OF CALIFORNIA | $2K | $0 | $2K | 1.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 20.26% |
| PAYCOR INC5 Filed as: PAYCOR, INC. | PO BOX 639860 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 6.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 6.10% |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC | 91 | $883K |
| Dental | DELTA DENTAL OF CALIFORNIA | 148 | $77K |
| Vision | VISION SERVICE PLAN | 100 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $38K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $38K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC | 91 | $883K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 148 | — |
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.