| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $70K | $0 | $70K | 4.98% |
| USI INSURANCE SERVICES LLC3 | WORLD TRADE CENTER MAIN STREET, SUITE 900 NORFOLK, VA 23510 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $46K | $0 | $46K | 3.98% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $51K | $49 | $51K | 5.94% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.47% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $303 | $0 | $303 | 2.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $366 | $0 | $366 | 8.99% |
| USI INSURANCE SERVICES LLC3 | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | HEALTH AND HUMAN RESOURCE CENTER, INC. | $221 | $0 | $221 | 10.02% |
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 | 411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 431 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 411 | $3.4M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 25 | $4K |
| Vision | VISION SERVICE PLAN | 253 | $33K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 411 | $851K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 411 | $851K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 411 | $851K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 411 | $3.4M |
| Other(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 411 | $875K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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."
No prospect flags tripped on this filing.