| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62937 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $44K | $13K | $58K | 2.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 92937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $4K | $12K | 12.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SERVICES LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 20.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 92937 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 12.86% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 12 GILL STREET STE 5500 WOBURN, MA 01801 | VSP | $61 | — | $61 | 7.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASS | 333 ELM STREET 3RD FLOOR DEDHAM, MA 02026 | VSP | $18 | — | $18 | 2.30% |
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 | 256 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 383 | $1.9M |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 127 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 256 | $100K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 256 | $100K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 256 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 383 | — |
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.