| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $200K | — | $200K | 2.30% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $10K | — | $10K | 0.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES SOUTHWEST | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | TELADOC | $144K | $0 | $144K | 12.58% |
| USI INSURANCE SERVICES LLC3 | 1787 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $252K | $0 | $252K | 26.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $65K | $0 | $65K | 10.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE, SUITE 2 HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $56K | $13K | $68K | 14.58% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $18K | $2K | $20K | 4.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33K | $0 | $33K | 14.17% |
| USI INSURANCE SERVICES LLC3 | 3805 WEST CHESTER PIKE SUITE 200 NEWTOWN SQUARE, PA 19073 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $17K | — | $17K | 25.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | — | $22 | 115.79% |
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 | 10,500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 136 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,636 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 10,500 | $3.9M |
| Dental | DELTA DENTAL OF NEW YORK | 1,979 | $350K |
| Vision | VISION SERVICE PLAN | 6,969 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 10,501 | $9.7M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 10,501 | $8.7M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 220 | $2.8M |
| Other(9 contracts, 9 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 10,501 | $11.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,501 | — |
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."
No prospect flags tripped on this filing.