| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE COMPANY | $310K | $50K | $360K | 5.22% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | 90 KREGIER LANE GLASTONBURY, CT 06033 | AETNA LIFE INSURANCE COMPANY | $22K | $0 | $22K | 0.32% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $11K | $2K | $13K | 0.19% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA HEALTH OF CALIFORNIA, INC. | $78K | $0 | $78K | 4.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $21K | $4K | $25K | 5.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 0.67% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $8K | $0 | $8K | 10.84% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET SUITE 2100 LOS ANGELES, CA 90017 | EMPATHIA PACIFIC, INC. | $652 | $0 | $652 | 5.00% |
| KACY LAVENDER4 Filed as: KACY K. LAVENDER | 307 SPRING CREEK MOODY, TX 76557 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $2K | $0 | $2K | 22.19% |
| ANGELA L HELENBERGER4 Filed as: ANGELA L. HELENBERGER | 15194 PALO PINTO DRIVE FRISCO, TX 75035 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $20 | $0 | $20 | 0.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $36 | $36 | — |
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 | 530 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 32 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,109 | $8.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,109 | $6.9M |
| Vision | VISION SERVICE PLAN | 459 | $69K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 530 | $459K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 530 | $459K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 530 | $459K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,109 | $8.6M |
| Other(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 1,109 | $7.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,109 | — |
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.