| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 7600 NORTH CAPITAL OF TX HIGHWAY SUITE B200 AUSTIN, TX 78731 | VISION SERVICE PLAN | $6K | — | $6K | 1.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | VISION SERVICE PLAN | $828 | — | $828 | 0.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 2.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $63 | $24K | 12.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 INTERNATIONAL PLAZA, SUITE 400 PHILADELPHIA, PA 19113 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $23 | $2K | 1.14% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24K | $5K | $28K | 27.52% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 879 12TH STREET HAMMONTON, NJ 08037 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19K | — | $19K | 25.09% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 46.61% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $186 | — | $186 | 4.99% |
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 | 3,484 | 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) | 3,484 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 9,788 | $419K |
| Dental | DELTA DENTAL OF NEW YORK | 862 | $164K |
| Vision | VISION SERVICE PLAN | 2,816 | $542K |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,241 | $2.7M |
| Short-term disability(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,241 | $2.7M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,241 | $2.6M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 82 | $419K |
| Other(9 contracts, 9 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,426 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,788 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.