| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1787 SENTRY PARKWAY WEST BUILDING 16, SUITE 300 BLUE BELL, PA 19422 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $107K | $107K | 1.99% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC. | 669 RIVER DRIVE CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $107K | $107K | 1.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $3K | $23K | 10.67% |
| USI INSURANCE SERVICES LLC3 | 2000 OXFORD DRIVE, SUITE 520 BETHEL PARK, PA 15102 | STANDARD INSURANCE COMPANY | $17K | $0 | $17K | 8.04% |
| USI INSURANCE SERVICES LLC3 | 1 INTERNATIONAL PLAZA, 4TH FLOOR PHILADELPHIA, PA 19113 | STANDARD INSURANCE COMPANY | $0 | $5K | $5K | 2.31% |
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 | 319 | 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) | 319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 258 | $5.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 860 | $215K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 258 | $5.4M |
| Life insurance | STANDARD INSURANCE COMPANY | 319 | $215K |
| Long-term disability | STANDARD INSURANCE COMPANY | 319 | $215K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 258 | $5.4M |
| Other | STANDARD INSURANCE COMPANY | 319 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 860 | — |
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.