| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $120K | $1 | $120K | 2.50% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | $7K | $33K | 12.61% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 2.40% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $50 | $50 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET SUITE 2100 LOS ANGELES, CA 90017 | HARVARD PILGRIM HEALTH CARE | $3K | $0 | $3K | 1.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $3K | $0 | $3K | 6.00% |
| USI INSURANCE SERVICES LLC3 | 777 SOUTH FIGEUROA STREET SUITE 2100 LOS ANGELES, CA 90017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 15.00% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD TORRANCE, CA 90503 | AETNA LIFE INSURANCE COMPANY | $416 | $48 | $464 | 2.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT LLC | 1166 AVENUE OF AMERICAS 22F 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 | 402 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 405 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 672 | $5.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 76 | $22K |
| Vision | VISION SERVICE PLAN | 345 | $56K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 402 | $263K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 402 | $263K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 402 | $263K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 672 | $5.2M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 402 | $329K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 672 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.