| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | EMBLEMHEALTH INC | $27K | $0 | $27K | 1.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 NORFOLK, VA 23514 | HORIZON HEALTHCARE OF NEW JERSEY, INC. | $7K | $0 | $7K | 1.03% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE FLORHAM PARK, NJ 07932 | HORIZON HEALTHCARE OF NEW JERSEY, INC. | $5K | $0 | $5K | 0.72% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT INSURANCE | $0 | $11K | $11K | 2.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT INSURANCE | $8K | $377 | $8K | 1.84% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER PERMANENTE INSURANCE COMPANY | $6K | $0 | $6K | 1.69% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $17K | $0 | $17K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 NORFOLK, VA 23514 | HORIZON HEALTHCARE SERVICES, INC. | $2K | $0 | $2K | 1.03% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE FLORHAM PARK, NJ 07932 | HORIZON HEALTHCARE SERVICES, INC. | $1K | $0 | $1K | 0.72% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | VISION SERVICE PLAN | $6K | $0 | $6K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $234 | $0 | $234 | 1.69% |
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 | 1,271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | EMBLEMHEALTH INC | 1,271 | $2.6M |
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 1,595 | $343K |
| Vision | VISION SERVICE PLAN | 482 | $65K |
| Life insurance | HARTFORD LIFE AND ACCIDENT INSURANCE | 1,301 | $429K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT INSURANCE | 1,301 | $429K |
| Prescription drug(4 contracts, 4 carriers) | EMBLEMHEALTH INC | 125 | $2.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE | 1,301 | $435K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,595 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.