| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | TUFTS INSURANCE COMPANY | $7K | — | $7K | 1.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | TUFTS INSURANCE COMPANY | — | $4K | $4K | 0.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 6500 WOBURN, MA 01801 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | $10K | — | $10K | 2.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $30K | — | $30K | 10.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | — | $2K | 4.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01888 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | $55K | — | $55K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | — | $27K | $27K | — |
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 | 644 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TUFTS INSURANCE COMPANY | 718 | $519K |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC | 931 | $384K |
| Vision | VISION SERVICE PLAN | 213 | $38K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 644 | $281K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 644 | $281K |
| Prescription drug(2 contracts, 2 carriers) | TUFTS INSURANCE COMPANY | 718 | $519K |
| Other | FEDERAL INSURANCE COMPANY | 644 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 931 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.