| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $134K | $0 | $134K | 2.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $25K | — | $25K | 0.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 S FL 12 SAINT LOUIS PARK, MN 554261205 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 2.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | CIGNA HEALTHCARE OF CALIFORNIA | $20K | $0 | $20K | 2.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | DEPT. 133667 P.O. BOX 39000 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO. | $22K | — | $22K | 3.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | DEPT. 133667 P.O. BOX 39000 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO. | — | $3K | $3K | 0.47% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT. 133667 P.O. BOX 39000 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 0.31% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P.O. BOX 39000 SAN FRANCISCO, CA 941390001 | VISION SERVICE PLAN | $3K | — | $3K | 5.00% |
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 | 630 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 636 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 788 | $5.9M |
| Dental | AETNA LIFE INSURANCE CO. | 1,091 | $656K |
| Vision | VISION SERVICE PLAN | 412 | $64K |
| Life insurance | AETNA LIFE INSURANCE CO. | 1,091 | $656K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 1,091 | $656K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 788 | $5.2M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,091 | $661K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,091 | — |
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."
No prospect flags tripped on this filing.