| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE CO. | $59K | $0 | $59K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE STE 102 FLORHAM PARK, NJ 07932 | DELTA DENTAL OF NEW JERSEY, INC. | $4K | — | $4K | 2.83% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE CO. | $4K | $0 | $4K | 3.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $3K | $0 | $3K | 2.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.21% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 1.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 234662939 | VISION SERVICE PLAN | $773 | — | $773 | 2.72% |
| DAN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 372058434 | VISION SERVICE PLAN | $772 | — | $772 | 2.71% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE STE 102 FLORHAM PARK, NJ 07932 | SILVER SCRIPT - CVS PHARMACY, INC | $0 | $0 | $0 | 0.00% |
| DANIEL OWEN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $272 | $0 | $272 | 2.70% |
| USI INSURANCE SERVICES LLC3 | 1441 MAIN ST, 15TH FL COLUMBIA, SC 29201 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $0 | $152 | 1.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $104 | $0 | $104 | 1.03% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE STE 102 FLORHAM PARK, NJ 07932 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $75 | $0 | $75 | 1.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9 | $0 | $9 | 1.18% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE STE 102 FLORHAM PARK, NJ 07932 | CARELON RX | $6K | $2.1M | $2.1M | — |
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 | 508 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF NEW JERSEY, INC. | 370 | $256K |
| Vision | VISION SERVICE PLAN | 256 | $28K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 484 | $119K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 419 | $76K |
| Prescription drug(2 contracts, 2 carriers) | SILVER SCRIPT - CVS PHARMACY, INC | 413 | $21K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 363 | $1.2M |
| Other(4 contracts, 3 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 484 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.