| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET, SUITE 21 LOS ANGELES, CA 90017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $125K | $0 | $125K | 2.59% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $41K | $7K | $48K | 11.17% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET SUITE 2100 LOS ANGELES, CA 90017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 0.70% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 1.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $462 | $462 | 0.16% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET SUITE 2100 LOS ANGELES, CA 90017 | HARVARD PILGRIM HEALTH CARE | $2K | $0 | $2K | 0.81% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $1K | $0 | $1K | 2.53% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | AETNA LIFE INSURANCE COMPANY | $578 | $231 | $809 | 3.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT, LLC | 1166 AVENUE OF AMERICAS, 22ND FLOOR NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $4K | $0 | $4K | 25.00% |
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 | 419 | 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) | 429 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 695 | $5.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 101 | $27K |
| Vision | VISION SERVICE PLAN | 350 | $58K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $432K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $432K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $432K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 695 | $5.3M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $448K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 695 | — |
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.