| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 320 WEST 57TH STREET NEW YORK, NY 10019 | METROPOLITAN LIFE INSURANCE INSURANCE COMPANY | $29K | $43 | $29K | 3.68% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE INSURANCE COMPANY | — | $14K | $14K | 1.84% |
| AMERICAN BENEFITS AND COMPENSATION3 | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $27K | — | $27K | 4.31% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | AETNA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 10.26% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | EYEMED VISION CARE | $5K | — | $5K | 7.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62939 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $3K | — | $3K | 4.85% |
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 | 1,149 | 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) | 1,149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | EMBLEMHEALTH SERVICES COMPANY, LLC | 139 | $2.4M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE INSURANCE COMPANY | 1,447 | $1.5M |
| Vision | EYEMED VISION CARE | 1,028 | $66K |
| Life insurance | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 74 | $635K |
| Long-term disability | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 74 | $635K |
| Prescription drug(3 contracts, 3 carriers) | EMBLEMHEALTH SERVICES COMPANY, LLC | 139 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,447 | — |
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.