| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI CALIFORNIA INS SVCS, LLC | 630 GERMANTOWN PIKE, STE 200 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIAN'S SERVICE | $23K | $269K | $292K | 1.64% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 61187 VIRGINIA BEACH, VA 234661187 | KAISER FOUNDATION HEALTH PLAN INC. | $128K | — | $128K | 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 | $42K | — | $42K | 2.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | P.O BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $133K | $22K | $155K | 14.53% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 61187 VIRGINIA BEACH, VA 234661187 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 2.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 90 S CASCADE AVE 2ND FLOOR COLORADO SPRINGS, CO 80903 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $24K | — | $24K | 5.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | P. O. BOX 39000 SAN FRANSISCO, CA 941390001 | VISION SERVICE PLAN | $5K | — | $5K | 1.93% |
| HAFT JOSEPH PETER3 | 321 33RD STREET SACRAMENTO, CA 95816 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $7K | — | $7K | 3.47% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 66119 VIRGINA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $1K | $4K | 20.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $321 | $3K | 18.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $50 | — | $50 | 16.08% |
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 | 2,930 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,930 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 1,204 | $27.0M |
| Vision | VISION SERVICE PLAN | 1,336 | $236K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,930 | $1.1M |
| Short-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,930 | $1.1M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,930 | $1.1M |
| Prescription drug(6 contracts, 5 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 1,204 | $27.0M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 80 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,930 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.