| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE COMPANY | $111K | $64 | $111K | 2.72% |
| USI INSURANCE SERVICES LLC3 | 600 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | $33K | $19 | $33K | 0.80% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $32K | $0 | $32K | 3.12% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA HEALTH OF CALIFORNIA INC. | $27K | $0 | $27K | 2.75% |
| USI INSURANCE SERVICES LLC3 | 600 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | AETNA HEALTH OF CALIFORNIA INC. | $8K | $0 | $8K | 0.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $54 | $1 | $55 | 5.58% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS OF CALIFORNIA | $34 | $0 | $34 | 3.45% |
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 | 403 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 506 | $6.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 506 | $4.1M |
| Prescription drug(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 506 | $6.1M |
| Other | BLUE CROSS OF CALIFORNIA | 403 | $985 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 506 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.