| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3475 PIEDMONT ROAD NE, SUITE 800 ATLANTA, GA 30305 | HARTFORD LIFE AND ACCIDENT | $37K | $0 | $37K | 1.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 201503 DALLAS, TX 75320 | VISION SERVICE PLAN | $34K | $0 | $34K | 9.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3475 PIEDMONT ROAD NE, SUITE 800 ATLANTA, GA 30305 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47K | $0 | $47K | 20.00% |
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 | 3,460 | 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) | 3,460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,422 | $344K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,460 | $2.3M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,460 | $2.3M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 3,460 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,460 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.