| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $196K | — | $196K | 3.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | DEPT 133667 P.O. BOX 39000 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO. | $40K | — | $40K | 0.68% |
| WELLS FARGO INSURANCE SERVICES Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 SOUTH SUITE 1200 ST. LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $16K | — | $16K | 0.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD. SUITE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $60 | $14K | 3.95% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVE STE 100 KING PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $9K | — | $9K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD. SUITE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $604 | — | $604 | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 19TH AVE STE 100 KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $206 | $206 | 1.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 959 SKYWAY RD 2ND FLOOR SAN CARLOS, CA 94070 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $381 | — | $381 | 15.56% |
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 | 799 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 803 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 1,205 | $5.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,191 | $378K |
| Vision | VISION SERVICE PLAN | 616 | $92K |
| Life insurance | AETNA LIFE INSURANCE CO. | 1,205 | $5.9M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 1,205 | $5.9M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 1,205 | $5.9M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,205 | $5.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,205 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.