| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, 11TH FLOOR SAN FRANCISCO, CA 94105 | WESTERN HEALTH ADVANTAGE | $34K | $0 | $34K | 4.98% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $17K | $0 | $17K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $0 | $4K | 5.05% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $311 | $6K | 14.23% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $473 | $0 | $473 | 4.35% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $308 | $0 | $308 | 2.83% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $92 | $0 | $92 | 2.02% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $321 | $0 | $321 | 19.69% |
| USI INSURANCE SERVICES LLC4 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $124 | $0 | $124 | 7.61% |
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 | 189 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 123 | $1.0M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 272 | $81K |
| Vision | VISION SERVICE PLAN | 117 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $48K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $44K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $44K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 123 | $1.0M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.