| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $95K | $95K | 1.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 840 GESSNER ROAD, SUITE 600 HOUSTON, TX 77024 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 0.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | VISION SERVICE PLAN | $9K | $0 | $9K | 0.78% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $51K | $10K | $62K | 17.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | FIRST UNUM LIFE INSURANCE COMPANY | $904 | $0 | $904 | 0.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $37K | $0 | $37K | 14.97% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 987 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $6K | $19K | 12.61% |
| UNKNOWN3 | UNKNOWN VALHALLA, NY 10595 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 3.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $141 | $2K | 1.55% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14K | $0 | $14K | 18.62% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE VALHALLA, NY 10595 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 2.27% |
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 | 7,420 | 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) | 7,420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 11,809 | $2.4M |
| Dental | DELTA DENTAL OF NEW YORK | 2,018 | $347K |
| Vision | VISION SERVICE PLAN | 5,368 | $1.1M |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,420 | $6.3M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,420 | $5.8M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,420 | $5.8M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 339 | $2.4M |
| Other(8 contracts, 8 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,420 | $7.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,809 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.