| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNITEDHEALTHCARE INSURANCE COMPANY | $134K | $0 | $134K | 5.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $86K | $0 | $86K | 3.80% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NJ 07932 | HARTFORD LIFE AND ACCIDENT | $20K | $3K | $24K | 10.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $0 | $2K | 2.99% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $344 | $0 | $344 | 2.48% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $293 | $0 | $293 | 10.02% |
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 | 289 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 318 | $4.8M |
| Vision | KAISER FOUNDATION HEALTH PLAN, INC. | 295 | $2.3M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 299 | $219K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 299 | $219K |
| Prescription drug(4 contracts, 4 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 318 | $4.8M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 299 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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.