| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | BLUE SHIELD OF CALIFORNIA | $154K | $20K | $175K | 2.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | $0 | $22K | 3.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA GROUP INSURANCE | $11K | $0 | $11K | 10.00% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS (37) | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20K | $2K | $22K | 23.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P.O. BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $3K | — | $3K | 2.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA GROUP INSURANCE | $17K | $0 | $17K | 20.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $2K | $0 | $2K | 3.50% |
| US INSURANCE SERVICES LLC3 Filed as: US INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA GROUP INSURANCE | $5K | $0 | $5K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA DENTAL HEALTH OF ILLINOIS AND KENTUCKY, INC. | $700 | $0 | $700 | 3.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA GROUP INSURANCE | $2K | $0 | $2K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA GROUP INSURANCE | $2K | $0 | $2K | 20.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | CIGNA DENTAL HEALTH OF OHIO, INC. | $303 | $0 | $303 | 3.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA GROUP INSURANCE | $702 | $0 | $702 | 9.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRAQNCE, CA 90503 | CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. | $127 | $0 | $127 | 3.50% |
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 | 1,390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,396 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 1,006 | $6.2M |
| Dental(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 966 | $824K |
| Vision | VISION SERVICE PLAN | 1,013 | $94K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 1,390 | $197K |
| Short-term disability(2 contracts, 2 carriers) | CIGNA GROUP INSURANCE | 426 | $210K |
| Long-term disability | CIGNA GROUP INSURANCE | 328 | $47K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 1,006 | $6.2M |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 1,390 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,390 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.