| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 200 BERKELEY STREET, 23RD FLOOR BOSTON, MA 02116 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $77K | $9K | $85K | 2.47% |
| USI INSURANCE SERVICES LLC3 | 200 BERKELEY STREET, 23RD FLOOR BOSTON, MA 02116 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | $0 | $35K | 6.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $49K | $0 | $49K | 15.01% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $41 | $41 | 0.01% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | $0 | $8K | $8K | 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 | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $7K | $7K | 12.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $6K | $0 | $6K | 11.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SOUTHWEST, INC. | PO BOX 201572 DALLAS, TX 75320 | VISION SERVICE PLAN | $715 | $0 | $715 | 2.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $626 | $0 | $626 | 2.25% |
| USI INSURANCE SERVICES LLC3 | 200 BERKELEY STREET, 23RD FLOOR BOSTON, MA 02116 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $72 | $0 | $72 | 5.99% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | 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 | 368 | $4.0M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 368 | $4.0M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 126 | $608K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $326K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $378K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $378K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 368 | $3.5M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $433K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 368 | — |
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.