| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 959 SKYWAY ROAD, 2ND FLOOR SAN FRANCISCO, CA 94070 | BLUE CROSS OF CALIFORNIA | $92K | $0 | $92K | 2.03% |
| USI INSURANCE SERVICES LLC3 | 213 SOUTH JEFFERSON STREET SW ROANOKE, VA 24011 | BLUE CROSS OF CALIFORNIA | $70K | $15K | $85K | 1.87% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203373 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $0 | $28K | 1.00% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $71 | $0 | $71 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT STREET, 8TH FLOOR SAN FRANCISCO, CA 94105 | DELTA DENTAL OF CALIFORNIA | $432 | $0 | $432 | 0.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.44% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $362 | $0 | $362 | 2.74% |
| USI INSURANCE SERVICES LLC3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $2K | $0 | $2K | 15.00% |
| HECTOR MATHA4 | 40754 FLYING SEA ROAD PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $748 | $0 | $748 | 8.42% |
| VINCENT P. FERANDA, IV4 | 774 VANDAL WAY PALMDALE, CA 93551 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $477 | $0 | $477 | 5.37% |
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 | 343 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 353 | $7.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 854 | $618K |
| Vision | VISION SERVICE PLAN | 320 | $114K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 275 | $4.5M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 275 | $4.5M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 275 | $4.5M |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 353 | $7.3M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 343 | $4.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 854 | — |
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.