| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 855 BOYLSTON STREET, 8TH FLOOR BOSTON, MA 02116 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $80K | $5K | $84K | 2.34% |
| USI INSURANCE SERVICES LLC3 | 855 BOYLSTON STREET, 8TH FLOOR BOSTON, MA 02116 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $43K | $0 | $43K | 6.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $24K | $0 | $24K | 10.18% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $6K | $6K | 2.69% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $297 | $297 | 0.12% |
| USI INSURANCE SERVICES LLC3 | 699 BOYLSTON STREET, 6TH FLOOR BOSTON, MA 02116 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $1K | $23K | 11.31% |
| USI INSURANCE SERVICES LLC3 | 855 BOYLSTON STREET, 8TH FLOOR BOSTON, MA 02116 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 6.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | $0 | $9K | $9K | 15.00% |
| USI INSURANCE SERVICES LLC3 | 855 BOYLSTON STREET, 8TH FLOOR BOSTON, MA 02116 | ZURICH AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 201572 DALLAS, TX 75320 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.73% |
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 | 215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 410 | $4.3M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 410 | $4.3M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 120 | $740K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 215 | $200K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 175 | $238K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 175 | $328K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 410 | $4.3M |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 215 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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."
No prospect flags tripped on this filing.