| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62939 VIRGINIA BEACH, VA 234662939 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $60 | $3K | 1.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 61007 VIRGINIA BEACH, VA 234661007 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.57% |
| EMERSON REID LLC3 | 167 ARCHER ROAD FACTORYVILLE, PA 18419 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $70 | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 | Direct payment from the plan; Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $2.1M |
| EXPRESS SCRIPTS EIN 22-3461740 | Claims processing; Other fees; Direct payment from the plan; Contract Administrator Service code 12 | — | $254K |
| VITECH SYSTEMS GROUP EIN 13-3785492 | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $106K |
| PETER J. RUFFNER EIN 13-1545680 | Employee (plan) Service code 30 | — | $100K |
| PRUDENTIAL RETIREMENT INS. ANNUITY EIN 06-1050034 | Custodial (other than securities); Investment management fees paid indirectly by plan; Custodial (securities) Service code 18 | — | $93K |
| INTECH INVESTMENT MANAGEMENT EIN 01-0614895 | Investment management; Investment management fees paid directly by plan Service code 28 | — | $93K |
| ROGER ROSS EIN 13-1545680 | Employee (plan) Service code 30 | — | $86K |
| LOUISE FURIO EIN 13-1545680 | Employee (plan) Service code 30 | — | $75K |
| THE SEGAL COMPANY EIN 13-1835864 | Insurance agents and brokers; Actuarial; Direct payment from the plan Service code 11 | — | $67K |
| JANUS CAPITAL MANAGEMENT EIN 04-3377381 | Investment management; Investment management fees paid directly by plan Service code 28 | — | $44K |
| KEVIN J. DRISCOLL EIN 13-1545680 | Employee (plan) Service code 30 | — | $44K |
| COLLERAN, O'HARA, MILLS LLP EIN 13-2940050 | Legal; Direct payment from the plan Service code 29 | — | $42K |
| SEAN DRISCOLL EIN 13-1545680 | Employee (plan) Service code 30 | — | $39K |
| SEGAL ADVISORS DBA SEGAL MARCO ADV EIN 13-2646110 | Investment advisory (plan); Investment management fees paid directly by plan; Consulting fees Service code 27 | — | $35K |
| SABINA WRIGHT EIN 13-1545680 | Employee (plan) Service code 30 | — | $33K |
| SEGAL SELECT INSURANCE EIN 46-0619194 | Insurance brokerage commissions and fees Service code 53 | — | $33K |
| INTEGRITY PHARMACEUTICAL ADVISORS EIN 45-3047652 | Direct payment from the plan; Actuarial Service code 11 | — | $31K |
| FRANCES MCCANN EIN 13-1545680 | Employee (plan) Service code 30 | — | $31K |
| LAPADULA, CARLSON & CO. CPA EIN 65-0292391 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $30K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $30K |
| JAMES C. WHITE EIN 13-1545680 | Employee (plan) Service code 30 | — | $26K |
| RITA MESSINA EIN 13-1545680 | Employee (plan) Service code 30 | — | $25K |
| CHUBB & SON EIN 13-1963496 | Insurance services; Direct payment from the plan; Insurance brokerage commissions and fees Service code 23 | — | $20K |
| BERDON LLP EIN 13-0485070 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $7K |
| AUTOMATIC DATA PROCESSING EIN 22-1467904 | Recordkeeping fees; Direct payment from the plan Service code 50 | — | $6K |
| DYNAMIC INDUSTRIES EIN 11-2467254 | Copying and duplicating; Direct payment from the plan Service code 36 | — | $6K |
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 | 2,596 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2,254 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,850 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 11,496 | $7.1M |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,534 | $189K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,534 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,496 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.