| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE PO BOX 1040 MERIDEN, CT 06450 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $15K | $23K | 2.92% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE PO BOX 1040 MERIDEN, CT 06450 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $7K | $7K | 1.91% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE PO BOX 1040 MERIDEN, CT 06450 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 1.87% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE PO BOX 1040 MERIDEN, CT 06450 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $955 | $4K | 9.60% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE PO BOX 1040 MERIDEN, CT 06450 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $603 | $603 | 1.67% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE PO BOX 1040 MERIDEN, CT 06450 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $118 | $118 | 1.78% |
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 | 3,018 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 79 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,097 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 71 | $241K |
| Dental | DELTA DENTAL PLAN OF NEW JERSEY INC. | 2,456 | $2.3M |
| Life insurance(4 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,018 | $1.0M |
| Short-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 108 | $7K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,593 | $353K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 71 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,018 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.