| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 6100 FAIRVIEW ROAD SUITE 1400 CHARLOTTE, NC 28210 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $71K | — | $71K | 2.41% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 75 REMITTANCE DRIVE SUITE 1926 CHICAGO, IL 60675 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $43K | — | $43K | 1.48% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | C/O NORTHERN TRUST BANK 75 REMITTANCE DR, SUITE 1446 CHICAGO, IL 60675 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | — | $6K | 2.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 48075 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 2.13% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 480751405 | UPMC HEALTH OPTIONS | $6K | — | $6K | 4.83% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | 625 LIBERTY AVENUE EQT PLAZA 10TH FLOOR PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $819 | — | $819 | 0.72% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 48075 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $3K | $455 | $3K | 8.93% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL | C/O NORTHERN TRUST BANK 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 7.44% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203318 DALLAS, TX 75320 | VISION SERVICE PLAN | $678 | — | $678 | 2.57% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 480751405 | VISION SERVICE PLAN | $99 | — | $99 | 0.38% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 480751405 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 7.58% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 625 LIBERTY AVENUE EQT PLAZA 10TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 7.42% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 625 LIBERTY AVENUE EQT PLAZA 10TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 7.59% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 480751405 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 7.41% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SER | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 48075 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $918 | $175 | $1K | 9.02% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL | C/O NORTHERN TRUST BANK 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $900 | — | $900 | 7.43% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 625 LIBERTY AVENUE EQT PLAZA 10TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $930 | — | $930 | 8.64% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 480751405 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $686 | — | $686 | 6.37% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 48075 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $596 | $413 | $1K | 15.73% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL | C/O NORTHERN TRUST BANK 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, ID 60675 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $366 | — | $366 | 5.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $254 | — | $254 | 5.01% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 625 LIBERTY AVENUE EQT PLAZA 10TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $253 | — | $253 | 4.99% |
| RON CHAMBERS4 | 3281 PLATEAU PLACE CINCINNATI, OH 45241 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $435 | — | $435 | 14.38% |
| USI INSURANCE SERVICES LLC4 Filed as: USI INS SERVICES NATION INC. | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 48075 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $416 | — | $416 | 13.75% |
| KEITH WANN4 | 2370 64TH STREET BROOKLYN, NY 11204 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $169 | — | $169 | 5.58% |
| KIMBERLY HAVENS4 Filed as: KIMBERLY B. BERGER GROOMS | 231 MEADOWBROOK DRIVE CRANBERRY TOWNSHIP, PA 16066 | PRE- PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $14 | — | $14 | 0.46% |
| WELLS FARGO INSURANCE SERVICES3 | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 40875 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $162 | $40 | $202 | 9.70% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL | C/O NORTHERN TRUST BANK 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $150 | — | $150 | 7.20% |
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 | 375 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 508 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 413 | $199K |
| Vision | VISION SERVICE PLAN | 299 | $26K |
| Life insurance(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 198 | $23K |
| Short-term disability(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 172 | $51K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 172 | $30K |
| Prescription drug(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 508 | $3.0M |
| Other(4 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 172 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.