| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET SAN FRANCISCO, CA 94105 | WESTERN HEALTH ADVANTAGE | $29K | $0 | $29K | 4.93% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $16K | $0 | $16K | 4.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 3.45% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $266 | $5K | 13.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $757 | $0 | $757 | 7.43% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 2.00% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $605 | $0 | $605 | 20.71% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET RANCHO CORDOVA, CA 95670 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $204 | $0 | $204 | 6.98% |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 69 | $970K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $80K |
| Vision | VISION SERVICE PLAN | 114 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 96 | $44K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 96 | $40K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 96 | $40K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 69 | $970K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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."
No prospect flags tripped on this filing.