| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 ATTN WEST VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $128K | $4K | $132K | 3.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVC WEST | 801 SOUTH FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | BLUE CROSS OF CALIFORNIA | $39K | — | $39K | 0.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 6100 FAIRVIEW ROAD STE 1400, 14TH FLOOR CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $4 | $703 | $707 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 150 N MICHIGAN AVE STE 3900 CHICAGO, IA 60601 | KAISER FOUNDATION HEALTH PLAN INC | $16K | — | $16K | 0.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 0.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | — | $4K | $4K | 0.12% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $2K | — | $2K | 1.29% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $756 | — | $756 | 0.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $744 | — | $744 | 0.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $493 | — | $493 | 3.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $2K | — | $2K | 15.00% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, 11TH FLOOR SAN FRANCISCO, CA 94105 | DELTA DENTA OF CALIFORNIA | $268 | — | $268 | 2.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTA OF CALIFORNIA | $205 | — | $205 | 2.17% |
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 | 338 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 351 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 453 | $7.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 804 | $608K |
| Vision | VISION SERVICE PLAN | 324 | $119K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 338 | $274K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 338 | $168K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 338 | $168K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 453 | $7.3M |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 345 | $302K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 804 | — |
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.