| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 530 PRESTON AVENUE, 3RD FLOOR MERIDEN, CT 06450 | AETNA LIFE INSURANCE COMPANY | — | $34K | $34K | 3.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | — | $5K | $5K | 0.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 NE 3RD AVENUE, SUITE 610 FORT LAUDERDALE, FL 33301 | AETNA LIFE INSURANCE COMPANY | — | $92 | $92 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $629 | $3K | 5.48% |
| PPI BENEFIT SOLUTIONS3 | 10 REARCH PARKWAY WALLINGFORD, CT 06492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $221 | $221 | 0.41% |
| SCHUSTER DRISCOLL LLC3 Filed as: SCHUSTER DRISCOLL AND COMPANY | 135 SOUTH ROAD FARMINGTON, CT 06032 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7 | -$3 | $4 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 530 PRESTON AVENUE, 3RD FLOOR MERIDEN, CT 06450 | ANTHEM HEALTH PLANS OF CONNECTICUT, INC. | $2K | — | $2K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $582 | — | $582 | 7.68% |
| SCHUSTER DRISCOLL LLC3 Filed as: SCHUSTER DRISCOLL, LLC | 135 SOUTH ROAD FARMINGTON, CT 06032 | EYEMED VISION CARE | $60 | — | $60 | 0.79% |
| ROSE & KIERNAN INC3 Filed as: ROSE AND KIERNAN, INC. | 99 TROY ROAD EAST GREENBUSH, NY 12061 | FEDERAL INSURANCE COMPANY | $173 | — | $173 | 15.04% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 106 | $890K |
| Dental | ANTHEM HEALTH PLANS OF CONNECTICUT, INC. | 60 | $47K |
| Vision | EYEMED VISION CARE | 88 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 126 | $54K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 126 | $54K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 126 | $54K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 106 | $890K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 126 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.