| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $39K | $43K | 2.20% |
| HEALTHY BUSINESS GROUP LLC3 Filed as: HEALTHY BUSINESS GROUP, LLC | 34 BAY STREET PO BOX 1346 SAG HARBOR, NY 11963 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.13% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF NEW YORK | $2K | — | $2K | 1.89% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | DELTA DENTAL OF NEW YORK | $743 | — | $743 | 0.61% |
| CHARLES A DUVALL III3 | 166 PIPPIN STREET ROANOKE, VA 24019 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $2K | $11K | 14.18% |
| RAYMOND B LINGLE3 | 3812 CONCORD PLACE ROANOKE, VA 24018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $405 | $2K | 2.24% |
| LINDA B ALLEN3 | 110 MOUNTAIN VIEW DRIVE ROCKY MOUNT, VA 24151 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $734 | $9 | $743 | 0.98% |
| JOHN E CUMMINGS3 | 204 QUAYSIDE CIRCLE STE 501 MAITLAND, FL 32751 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $596 | $23 | $619 | 0.82% |
| SANDRA LOWE LINGLE3 | 3812 CONCORD PLACE STE 6 ROANOKE, VA 24018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $290 | $20 | $310 | 0.41% |
| ALTON B BARTON3 | 1911 MAYLIN DRIVE SALEM, VA 24153 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 0.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $988 | $3K | 10.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 1800 HORIZON WAY STE 400 MT LAUREL, NJ 08054 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $404 | — | $404 | 1.43% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $1K | — | $1K | 6.68% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | PARK 80 WEST PLAZA TWO SADDLE BROOK, NJ 076635837 | EYEMED VISION CARE | $466 | — | $466 | 2.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $1K | $380 | $2K | 14.14% |
| MARSH & MCLENNAN AGENCY LLC3 | 18000 HORIZON WAY STE 400 MT LAUREL, NJ 08054 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $478 | — | $478 | 4.17% |
| CHARLES A DUVALL III3 | 166 PIPPIN ST ROANOKE, VA 24019 | THE PAUL REVERE LIFE INSURANCE COMPANY | $389 | — | $389 | 3.75% |
| RAYMOND B LINGLE3 | 3812 CONCORD PLACE ROANOKE, VA 24018 | THE PAUL REVERE LIFE INSURANCE COMPANY | $78 | — | $78 | 0.75% |
| LINDA B ALLEN3 | 110 MOUNTAIN VIEW DR ROCKY MOUNT, VA 24151 | THE PAUL REVERE LIFE INSURANCE COMPANY | $43 | — | $43 | 0.41% |
| JOHN E CUMMINGS3 | 204 QUAYSIDE CIR 501 MAITLAND, FL 32751 | THE PAUL REVERE LIFE INSURANCE COMPANY | $43 | — | $43 | 0.41% |
| HOWARD DILEMA3 | 100 JAY ST APT 14 J BROOKLYN, NY 11201 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.04% |
| TOMMY TAM3 | 418 EAST 74TH ST NEW YORK, NY 10021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.04% |
| FRANK M DARTEE3 | 12 MOONSHADOW CT KINNELON, NJ 07405 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 | Consulting (general) Service code 16 | — | $48K |
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 | 169 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 236 | $1.9M |
| Dental | DELTA DENTAL OF NEW YORK | 357 | $121K |
| Vision | EYEMED VISION CARE | 255 | $19K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 210 | $28K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 73 | $11K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 236 | $1.9M |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 210 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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.