| 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. | $67K | $0 | $67K | 5.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $50K | $733 | $51K | 4.03% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $43K | $83 | $44K | 6.28% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $238 | $0 | $238 | 2.05% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $273 | $0 | $273 | 9.56% |
| 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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 388 | $3.3M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 18 | $3K |
| Vision | VISION SERVICE PLAN | 246 | $31K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 388 | $692K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 388 | $692K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 388 | $692K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 388 | $3.3M |
| Other(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 388 | $714K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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.