| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA HEALTH, INC. | $31K | $0 | $31K | 2.75% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $27K | $5K | $32K | 3.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $27K | $0 | $27K | 5.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $41 | $4K | 2.81% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $456 | $456 | 0.35% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $41 | $41 | 0.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $3K | $59 | $3K | 2.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 10.15% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 2.75% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.91% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | $0 | $1K | 7.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $517 | $0 | $517 | 2.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $65 | $65 | 0.35% |
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 | 318 | 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) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA HEALTH, INC. | 196 | $2.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 366 | $150K |
| Vision | VISION SERVICE PLAN | 272 | $36K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 318 | $83K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 318 | $83K |
| Prescription drug(4 contracts, 4 carriers) | AETNA HEALTH, INC. | 196 | $2.7M |
| Other | HARTFORD LIFE AND ACCIDENT | 318 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 366 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.