| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $89K | $0 | $89K | 3.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21250 HAWTHORNE ROAD TORRANCE, CA 90503 | AETNA LIFE INSURANCE COMPANY | $39K | $6K | $45K | 2.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21250 HAWTHORNE ROAD TORRANCE, CA 90503 | AETNA HEALTH OF CALIFORNIA INC. | $24K | $0 | $24K | 1.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 333 SOUTH GRAND AVENUE LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $15K | $2K | $18K | 10.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 1.47% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | LOCKBOX 740659 LOS ANGELES, CA 90074 | HARTFORD LIFE AND ACCIDENT | $4 | $0 | $4 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | $0 | $1 | $1 | 0.00% |
| EPSIX, INC.3 | 13924 EAST DYER LANE SCOTTSDALE, AZ 85262 | HARTFORD LIFE AND ACCIDENT | -$453 | $0 | -$453 | -0.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | $0 | $4K | 10.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1787 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 33.25% |
| EPSIX, INC.3 | 13924 EAST DYER LANE SCOTTSDALE, AZ 85262 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 26.96% |
| JAMES ROBERT CONFORT3 | 3 SUNSET LANE GARDEN CITY, NY 11530 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $685 | $0 | $685 | 5.33% |
| CHRISTOPHER TARI3 Filed as: CHRISTOPHER JOHN TARI | 1179 WEBBER AVENUE SOUTH HEMPSTEAD, NY 11550 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $627 | $0 | $627 | 4.88% |
| PEREGRINE CONSULTING LLC3 Filed as: PEREGRINE CONSULTING, LLC | 162 BODINE ROAD BERWYN, PA 19312 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $299 | $0 | $299 | 2.33% |
| DUANE A TOWNSEND3 Filed as: DUANE ALAN TOWNSEND | 5101 LAUREL AVENUE CYPRESS, CA 90630 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $58 | $0 | $58 | 0.45% |
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 | 467 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 467 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 338 | $6.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 543 | $284K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 596 | $41K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 467 | $182K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 467 | $169K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 338 | $6.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 467 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 596 | — |
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.