| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI CALIFORNIA INS SVCS, LLC | 630 W GERMANTOWN PIKE STE 200 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIANS SERVICE | — | $86K | $86K | 4.34% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA PHYSICIANS SERVICE | — | $18K | $18K | 0.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI CALIFORNIA INS SVCS, LLC | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 3.68% |
| SABRA DAVIS3 | 675 HARTZ AVE STE 104 DANVILLE, CA 94526 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 4.97% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $3K | $8K | 4.33% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $258 | $185 | $443 | 0.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $5K | $12K | 14.59% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI CALIFORNIA INS SVCS, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $752 | — | $752 | 4.98% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $259 | — | $259 | 1.72% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 180 | $2.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 281 | $178K |
| Vision | VISION SERVICE PLAN | 111 | $15K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $80K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $80K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $80K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 20 | $203K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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.