| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICE LLC | PO BOX 3716 NORFOLK, VA 23514 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 9.92% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICE LLC | PO BOX 3716 NORFOLK, VA 23514 | SUN LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 4.36% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICE LLC | PO BOX 3716 NORFOLK, VA 23514 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $505 | — | $505 | 4.00% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICE LLC | PO BOX 3716 NORFOLK, VA 23514 | HARTFORD LIFE AND ACCIDENT | $113 | — | $113 | 15.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE CO. | Other fees; Other services; Custodial (securities) Service code 19 | 95 GLASTONBURY BLVD SUITE 102 GLASTONBURY, CT 06033 | $95K |
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 | 67 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 71 | $76K |
| Vision | ANTHEM HEALTH PLANS, INC. | 19 | $22K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY | 121 | $49K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 121 | $750 |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 71 | $76K |
| Other | BOSTON MUTUAL LIFE INSURANCE COMPANY | 121 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.