| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 1040 MERIDEN, CT 06450 | HPHC INSURANCE COMPANY | $38K | $0 | $38K | 2.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 1040 MERIDEN, CT 06450 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 4.61% |
| SCHUSTER DRISCOLL LLC3 | 135 SOUTH ROAD FARMINGTON, CT 06032 | UNITEDHEALTHCARE INSURANCE COMPANY | $359 | $0 | $359 | 0.39% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | ANTHEM LIFE INSURANCE COMPANY | $4K | $705 | $5K | 12.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SRVS & VARIOUS AGENTS | 555 PLEASANTVILLE ROAD SUITE 301N BRIARCLIFF MANOR, NY 10510 | AFLAC | $2K | $33 | $2K | 4.94% |
| JEANETTE A. COLE3 Filed as: JEANETTE A COLE | 185 PLAINS ROAD, SUITE 108E MILFORD, CT 06461 | AFLAC | $1K | $82 | $1K | 3.66% |
| FILIPE A COELHO3 | 4515 SOUTH MCCLINTOCK DRIVE SUITE 212 TEMPE, AZ 85282 | AFLAC | $803 | $21 | $824 | 2.16% |
| KENNETH C GRAVELINE3 | 20 CORRINE DRIVE PROSPECT, CT 06712 | AFLAC | $662 | $11 | $673 | 1.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 1040 MERIDEN, CT 06450 | AFLAC | $574 | $0 | $574 | 1.51% |
| CHRISTINE BLYSCHAK3 | 280 TWIN LAKES ROAD NORTH BRANFORD, CT 06471 | AFLAC | $473 | $81 | $554 | 1.45% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | AFLAC | $508 | $0 | $508 | 1.33% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | ANTHEM HEALTH PLANS, INC. | $776 | $71 | $847 | 8.20% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS, INC. | $341 | $0 | $341 | 3.30% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HPHC INSURANCE COMPANY | 184 | $1.4M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 211 | $92K |
| Vision | ANTHEM HEALTH PLANS, INC. | 203 | $10K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 160 | $39K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 160 | $39K |
| Prescription drug | HPHC INSURANCE COMPANY | 184 | $1.4M |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 160 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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.