| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE COMPANY | $323K | $22K | $345K | 4.75% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | 90 KREGIER LANE GLASTONBURY, CT 06033 | AETNA LIFE INSURANCE COMPANY | $16K | $0 | $16K | 0.22% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 0.09% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | AETNA HEALTH OF CALIFORNIA, INC. | $76K | $0 | $76K | 4.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $19K | $9K | $28K | 6.88% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $7K | $0 | $7K | 10.00% |
| KACY LAVENDER4 Filed as: KACY K. LAVENDER | 307 SPRINK CREEK MOODY, TX 76557 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $3K | $0 | $3K | 16.66% |
| ANGELA L HELENBERGER4 Filed as: ANGELA L. HELENBERGER | 15194 PALO PINTO DRIVE FRISCO, TX 75035 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $31 | $0 | $31 | 0.18% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET SUITE 2100 LOS ANGELES, CA 90017 | EMPATHIA PACIFIC, INC. | $0 | $734 | $734 | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $296 | $18 | $314 | 15.93% |
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 | 681 | 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) | 681 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,158 | $9.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,158 | $7.3M |
| Vision | VISION SERVICE PLAN | 506 | $72K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 629 | $408K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 629 | $408K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 629 | $408K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,158 | $9.0M |
| Other(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 1,158 | $7.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,158 | — |
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.