| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $77K | $2K | $79K | 2.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD, SUITE 800 CONCORD, CA 94520 | BLUE CROSS OF CALIFORNIA | $42K | — | $42K | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | 6100 FAIRVIEW ROAD STE 1400 14TH FLOOR CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | — | $6K | $6K | 0.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $5K | $128 | $6K | 2.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD, SUITE 800 CONCORD, CA 94520 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | 6100 FAIRVIEW ROAD STE 1400 14TH FLOOR CHARLOTTE, NC 28210 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $431 | $431 | 0.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $2K | $38 | $2K | 2.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD, SUITE 800 TULSA, OK 74114 | ANTHEM LIFE INSURANCE COMPANY | $875 | — | $875 | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | 6100 FAIRVIEW ROAD STE 1400 14TH FLOOR CHARLOTTE, NC 28210 | ANTHEM LIFE INSURANCE COMPANY | — | $128 | $128 | 0.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC (LA) | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $750 | — | $750 | 14.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC (SF) | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $99 | — | $99 | 1.98% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $49 | $49 | 0.98% |
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 | 295 | 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) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 436 | $3.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 870 | $227K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 870 | $227K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 870 | $227K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 269 | $67K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 269 | $67K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 436 | $3.2M |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 870 | $299K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 870 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.