| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $51K | $0 | $51K | 4.51% |
| USI INSURANCE SERVICES LLC3 | 575 MARKET STREET, SUITE 3750 SAN FRANCISCO, CA 94105 | UNITEDHEALTHCARE INSURANCE COMPANY | $17K | $0 | $17K | 5.52% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES, INC. | 500 YGNACIO VALLEY ROAD, SUITE 450 WALNUT CREEK, CA 94596 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | $0 | $8K | 2.76% |
| USI INSURANCE SERVICES LLC3 | 800 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $4K | $0 | $4K | 1.94% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, SUITE 1100 SAN FRANCISCO, CA 94105 | SUTTER HEALTH PLAN | $10K | $0 | $10K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $3K | $9K | 7.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $9K | 14.33% |
| USI INSURANCE SERVICES LLC3 | 800 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $1K | $0 | $1K | 1.86% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | UNITEDHEALTHCARE OF CALIFORNIA | $2K | $0 | $2K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $704 | $359 | $1K | 89.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.25% |
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 144 | $1.9M |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $131K |
| Vision(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $131K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $62K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $62K |
| Prescription drug(6 contracts, 6 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 144 | $1.9M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.