| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR BLOOMINGTON, MN 55437 | AETNA LIFE INSURANCE CO. | $13K | — | $13K | 1.30% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR CAMDEN, NJ 08103 | AETNA LIFE INSURANCE CO. | $10K | — | $10K | 0.99% |
| USI INSURANCE SERVICES LLC3 | 600 HWY 169S ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $7K | $83 | $7K | 0.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 600 HIGHWAY 169 SOUTH ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $6K | — | $6K | 0.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES OF NEW YOR | UNKNOWN NEW YORK, NY 10279 | AETNA LIFE INSURANCE CO. | — | $14 | $14 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 312 ELM ST FL 24 CINCINNATI, OH 452022701 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $668 | $668 | 1.75% |
| CORPORATE SYNERGIES GROUP LLC3 | 1540 CORNERSTONE BLVD STE 200 DAYTONA BEACH, FL 321177144 | UNITEDHEALTHCARE INSURANCE COMPANY | $402 | — | $402 | 1.05% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE STE 1 FLORHAM PARK, NJ 079321054 | UNITEDHEALTHCARE INSURANCE COMPANY | $159 | — | $159 | 0.42% |
| USI INSURANCE SERVICES LLC3 | ENTERPRISE LICENSING CENTER 601 UNION ST SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | — | $42 | $42 | 0.18% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $328 | $287 | $615 | 14.38% |
| CORPORATE SYNERGIES GROUP LLC3 | FERRY TERMINAL BUILDING 2 AQUARIUM DRIVE CAMDEN, NJ 08103 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $100 | — | $100 | 2.34% |
| USI INSURANCE SERVICES LLC3 | 7 GIRALDA FARMS 2ND FL MADISON, NJ 07940 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | — | $1K | 30.25% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE STE 102 FLORHAM PARK, NJ 07932 | FIRST UNUM LIFE INSURANCE COMPANY | — | $114 | $114 | 2.97% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 132 | $976K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 100 | $38K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 57 | $4K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 100 | $23K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 100 | $23K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 100 | $23K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 100 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.