| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN, SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN, INC. | $71K | $0 | $71K | 2.92% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 380 TORRANCE, CA 90503 | AETNA LIFE INSURANCE COMPANY | $33K | $14K | $47K | 2.85% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | AETNA HEALTH OF CALIFORNIA INC. | $24K | $0 | $24K | 2.19% |
| USI INSURANCE SERVICES LLC3 | 333 SOUTH GRAND AVENUE LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $13K | $0 | $13K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $16K | $3K | $19K | 13.12% |
| EPSIX, INC.3 | 3300 NORTH SCOTTSDALE ROAD UNIT 4020 SCOTTSDALE, AZ 85251 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 1.47% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | $0 | $4K | 9.98% |
| USI INSURANCE SERVICES LLC3 | 190 RIVER ROAD, SUITE 101 SUMMIT, NJ 07901 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 38.19% |
| EPSIX, INC.3 | 3300 NORTH SCOTTSDALE ROAD APARTMENT 4020 SCOTTSDALE, AZ 85251 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 32.89% |
| JAMES ROBERT CONFORT3 | 3 SUNSET LANE GARDEN CITY, NY 11530 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 11.71% |
| CHRISTOPHER TARI3 Filed as: CHRISTOPHER JOHN TARI | 1179 WEBBER AVENUE SOUTH HEMPSTEAD, NY 11550 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.74% |
| PEREGRINE CONSULTING LLC3 Filed as: PEREGRINE CONSULTING, LLC | 162 BODINE ROAD BERWYN, PA 19312 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $332 | $0 | $332 | 2.45% |
| DUANE A TOWNSEND3 Filed as: DUANE ALAN TOWNSEND | 5825 LINCOLN AVENUE, SUITE D441 BUENA PARK, CA 90620 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $132 | $0 | $132 | 0.97% |
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 | 390 | 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) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 320 | $5.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 602 | $254K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 536 | $36K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 436 | $155K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 436 | $142K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 320 | $5.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 436 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 602 | — |
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.