| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 630 WEST GERMANTOWN PIKE, SUITE 20 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $227K | $227K | 1.52% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $93K | $0 | $93K | 2.16% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER, SUITE 250 IRVINE, CA 92618 | DELTA DENTAL OF CALIFORNIA | $23K | $0 | $23K | 2.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $23K | $0 | $23K | 2.67% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 1.18% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $617 | $617 | 0.07% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.02% |
| USI INSURANCE SERVICES LLC3 | 1 CONCOURSE CENTER PARKWAY NE SUITE 700 ATLANTA, GA 30328 | ARAG INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
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 | 2,877 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,887 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 1,785 | $19.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,561 | $1.2M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,339 | $134K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,877 | $870K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,877 | $870K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,877 | $870K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 1,785 | $19.3M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,877 | $966K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,877 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.