| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 7600B NORTH CAPITAL OF TX HIGHWAY SUITE 200 AUSTIN, TX 78731 | CALIFORNIACHOICE | $37K | — | $37K | 6.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 7600B NORTH CAPITAL OF TX HIGHWAY SUITE 200 AUSTIN, TX 78731 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | $1K | $16K | 11.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 5.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $3K | $13K | 12.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 1.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $945 | $237 | $1K | 13.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2711 NORTH HASKELL AVENUE SUITE 2000 DALLAS, TX 75204 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $70 | — | $70 | 0.78% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 88 | $564K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 347 | $113K |
| Vision | CALIFORNIACHOICE | 88 | $564K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 340 | $142K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 340 | $142K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 340 | $142K |
| Prescription drug | CALIFORNIACHOICE | 88 | $564K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 340 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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.