| 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 | $113K | $2K | $114K | 5.33% |
| USI INSURANCE SERVICES LLC3 | 1039-A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | BLUE CROSS OF CALIFORNIA | $10K | $0 | $10K | 0.44% |
| USI INSURANCE SERVICES LLC3 | 1039A NORTH MCDOWELL BOULEVARD SUITE 250 PETALUMA, CA 94954 | KAISER FOUNDATION HEALTH PLAN | $56K | $0 | $56K | 3.10% |
| USI INSURANCE SERVICES LLC3 | PO BOX 601146 CHARLOTTE, NC 28260 | MANAGED HEALTH NETWORK | $867 | $0 | $867 | 4.06% |
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 | 339 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 518 | $4.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 518 | $2.1M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 518 | $2.1M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 518 | $2.1M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 518 | $4.0M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 536 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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.