| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SACRAMENTO, CA 95864 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $65K | — | $65K | 5.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $65K | — | $65K | 5.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 61187 VIRGINA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 2.00% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 1.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $4K | $7K | 13.24% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $4K | $6K | 13.49% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $6K | 13.05% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 12.87% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $891 | $2K | $2K | 13.62% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $897 | — | $897 | 5.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $769 | $1K | $2K | 12.50% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $838 | — | $838 | 5.22% |
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 | 400 | 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) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 251 | $2.1M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 400 | $74K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $44K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 85 | $42K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 251 | $2.1M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 400 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.