| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $140K | $12K | $152K | 1.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $88K | $0 | $88K | 4.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $136K | $21K | $158K | 16.23% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 1.20% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 0.26% |
| USI INSURANCE SERVICES LLC3 | 16745 WEST BERNARDO DRIVE SUITE 140 SAN DIEGO, CA 92127 | DELTA DENTAL OF CALIFORNIA | $41K | $0 | $41K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNUM INSURANCE COMPANY | $9K | $2K | $11K | 16.55% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.98% |
| USI INSURANCE SERVICES LLC3 | 16745 WEST BERNARDO DRIVE SUITE 140 SAN DIEGO, CA 92127 | EMPATHIA PACIFIC, INC. | $678 | $0 | $678 | 6.25% |
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 | 424 | 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) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 589 | $10.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 852 | $408K |
| Vision | VISION SERVICE PLAN | 411 | $43K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $972K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $972K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $972K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 589 | $10.8M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 852 | — |
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.