| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE NATIONAL, INC. | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIAN'S SERVICE | $235K | $6K | $241K | 1.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 150 N MICHIGAN AVE SUITE 3900 CHICAGO, IL 606017604 | KAISER FOUNDATION HEALTH PLAN INC. | $147K | — | $147K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES USA | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $38K | — | $38K | 2.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $41K | — | $41K | 4.86% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 606017604 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 2.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 90 S CASCADE AVE COLORADO SPRINGS, CO 80903 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $24K | $608 | $25K | 5.08% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA, | P. O. BOX 39000 SAN FRANSISCO, CA 941390001 | VISION SERVICE PLAN | $4K | — | $4K | 1.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | — | VISION SERVICE PLAN | $880 | — | $880 | 0.37% |
| HAFT JOSEPH PETER3 | 321 33RD STREET SACRAMENTO, CA 95816 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $7K | — | $7K | 3.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | LOCK BOX DEPARTMENT 33720 P.O. BOX 39000 SAN FRANCISCO, CA 94139 | MUTUAL OF OMAHA INSURANCE COMPANY | $529 | — | $529 | 2.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | — | $2K | 16.00% |
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 | 2,600 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,600 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 1,154 | $24.3M |
| Vision | VISION SERVICE PLAN | 1,361 | $235K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,484 | $864K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,484 | $856K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,484 | $843K |
| Prescription drug(6 contracts, 5 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 1,154 | $24.3M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 219 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,484 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.