| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10592 | EMBLEMHEALTH | $123K | — | $123K | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 333 WESTCHESTER AVENUE SUITE 102 WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 5.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62939 VIRGINIA BEACH, VA 23466 | AETNA LIFE INSURANCE COMPANY | $1K | — | $1K | 0.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | — | $114 | $114 | 0.07% |
| EMERSON REID LLC3 Filed as: EMERSON REID AND COMPANY | 261 MADISON AVENUE, SUITE 602 NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $7K | $3K | $10K | 17.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | — | $273 | $273 | 0.48% |
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 | 387 | 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) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEMHEALTH | 273 | $3.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 480 | $171K |
| Vision | AETNA LIFE INSURANCE COMPANY | 480 | $171K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 388 | $57K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 388 | $57K |
| Prescription drug | EMBLEMHEALTH | 273 | $3.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 388 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 480 | — |
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.