| 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 | $0 | $50K | $50K | 1.25% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $10K | $10K | 3.85% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.71% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $775 | $23 | $798 | 1.79% |
| USI INSURANCE SERVICES LLC3 | 3440 WALNUT AVENUE BUILDING A, 2ND FLOOR FREMONT, CA 94538 | METLIFE LEGAL PLANS | $449 | $0 | $449 | 6.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $141 | $70 | $211 | 3.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 25277 TAMPA, FL 33622 | METLIFE LEGAL PLANS | $0 | $41 | $41 | 0.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203318 DALLAS, TX 75320 | METLIFE LEGAL PLANS | $0 | $8 | $8 | 0.11% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $552 | $0 | $552 | 8.22% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $184 | $0 | $184 | 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 | 570 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 581 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 861 | $4.1M |
| Dental(2 contracts, 2 carriers) | PREMIER ACCESS INSURANCE COMPANY | 1,110 | $629K |
| Vision | ARMADACARE | 13 | $168K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 574 | $311K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 145 | $44K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 574 | $267K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 861 | $4.1M |
| Other(5 contracts, 5 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 574 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,110 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.