| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | UNKNOWN MEDFORD, MA 02155 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $99K | $18K | $117K | 2.59% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $92K | $0 | $92K | 15.48% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $71 | $71 | 0.01% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN MEDFORD, MA 02155 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $30K | $0 | $30K | 6.58% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | $0 | $8K | $8K | 20.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 162937 VIRGINIA BEACH, VA 23466 | ZURICH AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $2K | $293 | $3K | 16.98% |
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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 289 | 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, INC. | 504 | $5.0M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 504 | $5.0M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 155 | $494K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 299 | $596K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 299 | $596K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 299 | $596K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 504 | $4.5M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 299 | $653K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.