| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | EMBLEMHEALTH | $85K | $0 | $85K | 2.20% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $8K | $7K | $14K | 8.85% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $12K | $20K | 16.62% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY WEST, VEVA 16 BLUE BELL, PA 19422 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $624 | $120 | $744 | 4.79% |
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 | 569 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 571 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEMHEALTH | 331 | $3.9M |
| Dental | AETNA LIFE INSURANCE COMPANY | 397 | $164K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 266 | $16K |
| Life insurance | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 456 | $121K |
| Long-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 456 | $121K |
| Prescription drug | EMBLEMHEALTH | 331 | $3.9M |
| Other | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 456 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 456 | — |
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.