| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER ROAD, 1ST FLOOR SUMMIT, NJ 07901 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $157K | $2K | $159K | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 580 N. 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $36K | $15K | $52K | 7.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P.O. BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $3K | — | $3K | 2.55% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 20.01% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 9000 E. HAMILTON AVENUE, SUITE 100 CAMPBELL, CA 95008 | FEDERAL INSURANCE COMPANY | $750 | — | $750 | 14.99% |
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 | 622 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 76 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 698 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,666 | $12.3M |
| Vision | VISION SERVICE PLAN | 476 | $103K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 622 | $696K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 622 | $696K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 622 | $696K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 1,666 | $12.3M |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 622 | $701K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,666 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.