| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN METUCHEN, NJ 08840 | BLUECHOICE HEALTHPLAN | $54K | $0 | $54K | 2.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 10.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $173 | $3K | 7.25% |
| USI INSURANCE SERVICES LLC3 | 333 EARLE OVINGTON BOULEVARD SUITE 80 UNIONDALE, NY 11553 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.97% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY WEST SUITE 320 BLUE BELL, NY 19422 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 4.82% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $520 | $4K | 29.24% |
| USI INSURANCE SERVICES LLC3 | 300 EXECUTIVE DRIVE, SUITE 380 WEST ORANGE, NJ 07052 | STANDARD INSURANCE COMPANY | $720 | $0 | $720 | 14.99% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | $0 | $800 | $800 | 20.00% |
| USI INSURANCE SERVICES LLC3 | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | ACE AMERICAN INSURANCE COMPANY | $600 | $0 | $600 | 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 | 192 | 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) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECHOICE HEALTHPLAN | 131 | $2.0M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 119 | $66K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 288 | $59K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 53 | $12K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 288 | $64K |
| Prescription drug | BLUECHOICE HEALTHPLAN | 131 | $2.0M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 288 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.