| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA, EAST TOWER UNIONDALE, NY 11553 | EMBLEM HEALTH, INC. | $28K | $0 | $28K | 1.98% |
| USI INSURANCE SERVICES LLC3 | 300 EXECUTIVE DRIVE WEST ORANGE, NJ 07052 | HORIZON HEALTHCARE SERVICES, INC. | $12K | $0 | $12K | 1.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $7K | $7K | 2.37% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $5K | $0 | $5K | 1.71% |
| USI INSURANCE SERVICES LLC3 | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FORT LAUDERDALE, FL 33308 | HARTFORD LIFE AND ACCIDENT | $117 | $0 | $117 | 0.04% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $16K | $0 | $16K | 5.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $0 | $4K | 1.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $3K | $0 | $3K | 5.55% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.72% |
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 | 1,003 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,010 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | EMBLEM HEALTH, INC. | 121 | $2.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,325 | $301K |
| Vision | VISION SERVICE PLAN | 408 | $58K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,003 | $307K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,003 | $307K |
| Prescription drug(3 contracts, 3 carriers) | EMBLEM HEALTH, INC. | 121 | $2.4M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,003 | $312K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,325 | — |
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.