| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BL SUITE 600 TORRANCE, CA 90503 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $178K | — | $178K | 5.45% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $13K | — | $13K | 0.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P O BOX 39000 SAN FRANCISCO, CA 94139 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $4K | $4K | 0.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P O BOX 203417 DALLAS, TX 75320 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $127 | $127 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $57 | $21K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 1.61% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 4.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 0.93% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 0.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P O BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $1K | — | $1K | 3.81% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $1K | — | $1K | 8.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS INC, A CALIFORNIA CORPORATION | $119 | — | $119 | 4.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVENUE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS INC, A CALIFORNIA CORPORATION | — | $38 | $38 | 1.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | SAFEGUARD HEALTH PLANS INC, A CALIFORNIA CORPORATION | $30 | — | $30 | 1.15% |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 492 | $3.3M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 720 | $429K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 219 | $50K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 492 | $3.5M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 209 | $280K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 209 | $280K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 492 | $3.3M |
| Other | HARTFORD LIFE AND ACCIDENT | 209 | $280K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 720 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.