| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $98K | $39K | $137K | 7.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $46K | $17K | $64K | 4.91% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10016 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $52K | $0 | $52K | 4.53% |
| RANDALL WARREN PECK3 Filed as: RANDALL W. PECK | 7100 WEST CAMINO REAL, SUITE 403 BOCA RATON, FL 33433 | PACIFIC LIFE AND ANNUITY COMPANY | $17K | $0 | $17K | 3.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $9K | $8K | $17K | 3.76% |
| HOWARD B. COWAN3 | 90 PARK AVENUE, 17TH FLOOR NEW YORK, NY 10016 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.36% |
| MICHAEL A BOOK3 Filed as: MICHAEL A. BOOK | 90 PARK AVENUE, 17TH FLOOR NEW YORK, NY 10016 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.36% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $30K | $16K | $46K | 26.44% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 18100 VON KARMAN AVENUE IRVINE, CA 92612 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $5K | $5K | 2.59% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS AND COMP. SYSTEMS | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | — | $2K | 1.35% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 HUDSON STREET, 4TH FLOOR NEW YORK, NY 10014 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $203 | $0 | $203 | 0.12% |
| USI INSURANCE SERVICES LLC3 | 300 EAST MAIN STREET, SUITE 1300 NORFOLK, VA 23510 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $186 | $0 | $186 | 0.11% |
| PECK FINANCIAL SERVICES INC3 Filed as: PECK FINANCIAL, INC. | 7100 CAMINO REAL, SUITE 403 BOCA RATON, FL 33433 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $71 | $48 | $119 | 0.07% |
| LOCKTON COMPANIES, LLC3 | PO BOX 741738 ATLANTA, GA 30374 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $39 | $0 | $39 | 0.02% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS INC | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $17 | $17 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 5.69% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $0 | $4K | $4K | 20.00% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | FEDERAL INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $0 | $1K | $1K | 20.00% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | FEDERAL INSURANCE COMPANY | $786 | $0 | $786 | 15.00% |
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 | 1,871 | 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) | 1,871 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 121 | $3.7M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,034 | $2.5M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,686 | $94K |
| Life insurance(4 contracts, 4 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 1,871 | $2.4M |
| Short-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,817 | $2.1M |
| Long-term disability(3 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,817 | $3.2M |
| Prescription drug(3 contracts, 3 carriers) | EMBLEM HEALTH | 106 | $2.5M |
| Other(4 contracts, 3 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 1,285 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,034 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.