| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $10K | $8K | $18K | 3.54% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21600 OXNARD STREET, 8TH FLOOR WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $11K | — | $11K | 2.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $11K | — | $11K | 2.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21600 OXNARD STREET, 8TH FLOOR WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 1.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | AETNA LIFE INSURANCE COMPANY | — | $114 | $114 | 0.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21600 OXNARD STREET, SUITE 830 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $16K | — | $16K | 4.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | UNION SECURITY INSURANCE COMPANY | $10K | — | $10K | 6.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | VISION SERVICE PLAN | $992 | — | $992 | 6.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 38 DISCOVERY, SUITE 250 IRVINE, CA 92618 | UDC DENTAL OF CALIFORNIA, INC. | $1K | — | $1K | 10.00% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 109 | $1.3M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 206 | $166K |
| Vision | VISION SERVICE PLAN | 126 | $16K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 206 | $152K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 206 | $152K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 109 | $1.3M |
| Other | UNION SECURITY INSURANCE COMPANY | 206 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.