| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $21K | $0 | $21K | 7.21% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $20K | $0 | $20K | 7.04% |
| ARCHON LLC3 Filed as: ARCHON, LLC | 225 WIRELESS BOULEVARD HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $12K | $12K | 4.20% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $0 | $8K | 3.68% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | $0 | $6K | 2.77% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $993 | $0 | $993 | 3.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $374 | $0 | $374 | 1.37% |
| USI INSURANCE SERVICES LLC3 | 575 MARKET STREET, SUITE 3750 SAN FRANCISCO, CA 94105 | FEDERAL INSURANCE COMPANY | $380 | $29 | $409 | 21.53% |
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 | 129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 23 | $205K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $288K |
| Vision | VISION SERVICE PLAN | 123 | $27K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $288K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $288K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $288K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 23 | $205K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $290K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.