| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $25K | — | $25K | 4.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC. | $21K | — | $21K | 4.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $5K | — | $5K | 4.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | $720 | — | $720 | 5.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $699 | $393 | $1K | 15.62% |
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 | 163 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | SUTTER HEALTH PLAN | 81 | $1.0M |
| Vision | VISION SERVICE PLAN | 122 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $7K |
| Prescription drug(3 contracts, 3 carriers) | SUTTER HEALTH PLAN | 81 | $1.0M |
| Other(4 contracts, 4 carriers) | SUTTER HEALTH PLAN | 163 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.