| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | UNITEDHEALTHCARE INSURANCE COMPANY | $117K | $0 | $117K | 3.67% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND AND COMPANY LLC | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | UNUM LIFE INSURANCE COMPANY | $6K | $1K | $7K | 4.75% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DRIVE COURT II SUITE 305 ELMWOOD PARK, NJ 07407 | HARTFORD LIFE AND ACCIDENT | $6K | $3K | $9K | 14.51% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 5.36% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY WEST VEVA 16 SUITE 320 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 23.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITIAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 8.62% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PARKWAY WEST BUILDING 16, SUITE 320 BLUE BELL, PA 19422 | METROPOLITIAN LIFE INSURANCE COMPANY | $2K | $656 | $3K | 6.11% |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 292 | $3.2M |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 108 | $164K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY | 105 | $157K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 292 | $3.2M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.