| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 213 SOUTH JEFFERSON STREET SW ROANOKE, VA 24011 | BLUE CROSS OF CALIFORNIA | $136K | $9K | $145K | 3.18% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | BLUE CROSS OF CALIFORNIA | $21K | $0 | $21K | 0.46% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $14 | $24K | 0.92% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, 11TH FLOOR SAN FRANCISCO, CA 94105 | DELTA DENTAL OF CALIFORNIA | $447 | $0 | $447 | 0.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.86% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $430 | $0 | $430 | 3.25% |
| HECTOR MATHA4 | 54565 AVENIDA DIAZ LA QUINTA, CA 92253 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $939 | $0 | $939 | 7.39% |
| VINCENT P. FERANDA, IV4 | PO BOX 901772 PALMDALE, CA 93590 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $884 | $0 | $884 | 6.96% |
| 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% |
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 | 345 | 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) | 349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 333 | $7.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 816 | $606K |
| Vision | VISION SERVICE PLAN | 327 | $112K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 274 | $4.6M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 274 | $4.6M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 274 | $4.6M |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 333 | $7.2M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 345 | $4.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 816 | — |
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.