| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $66K | — | $66K | 4.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $26K | — | $26K | 14.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES CORP | 200 SUMMIT LAKE DR STE 350 VALHALLA, NY 10595 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 5.39% |
| PROGRESSIVE PLAN ADMINISTRATORS3 Filed as: PROGRESSIVE PLAN ADMIN | 261 MADISON AVENUE 5TH FLOOR NEW YORK, NY 10016 | EMBLEM HEALTH | $329 | — | $329 | 2.32% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVE FL 5 NEW YORK, NY 100162303 | VSP - VISION SERVICE PLAN | $741 | — | $741 | 7.55% |
| J.P. WEST INC.3 Filed as: J.P. WEST, INC | 44 WALL STREET 12TH FLOOR NEW YORK, NY 100050000 | FEDERAL INSURANCE COMPANY | $225 | — | $225 | 15.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $461 | — | $461 | 32.22% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES CORP | 200 SUMMIT LAKE DR STE 350 VALHALLA, NY 10595 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| PROGRESSIVE PLAN ADMINISTRATORS3 Filed as: PROGRESSIVE PLAN ADMIN | 261 MADISON AVENUE 5TH FLOOR NEW YORK, NY 10016 | EMBLEM HEALTH | $10 | — | $10 | 7.87% |
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 | 84 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 87 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 87 | $1.7M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 84 | $74K |
| Vision | VSP - VISION SERVICE PLAN | 86 | $10K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 151 | $186K |
| Long-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 138 | $186K |
| Other(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 151 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.