| 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 | $279K | $279K | 1.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $97K | $0 | $97K | 1.99% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | DELTA DENTAL OF CALIFORNIA | $24K | $0 | $24K | 2.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $27K | $37K | 3.28% |
| USI INSURANCE SERVICES LLC3 | CONCOURSE PARKWAY NE ATLANTA, GA 30328 | AETNA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 37.35% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $52 | $52 | 0.07% |
| USI INSURANCE SERVICES LLC3 | CONCOURSE 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 | 2,958 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,967 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 1,770 | $23.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,102 | $1.2M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,342 | $137K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,958 | $1.1M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,958 | $1.1M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,958 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 1,770 | $23.3M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,998 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,998 | — |
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.