| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | MVP HEALTHCARE | $42K | $0 | $42K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 9.20% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE COMPANY | $5K | $2K | $7K | 22.55% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $1K | $3K | 14.50% |
| USI INSURANCE SERVICES LLC3 | 333 GLEN STREET GLENS FALLS, NY 12801 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.78% |
| MELISSA PINE3 Filed as: MELISSA BEAUCHEMIN | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $766 | $16 | $782 | 6.20% |
| DONALD H MATSON3 Filed as: DONALD H. MATSON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $405 | $133 | $538 | 4.27% |
| LORRAINE RHODES3 | 4A KENSINGTON COURT CLIFTON PARK, NY 12065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $499 | $0 | $499 | 3.96% |
| BRIAN BEAUCHEMIN3 | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $218 | $0 | $218 | 1.73% |
| B AND B INSURNACE SOLUTIONS INC3 | 14716 SOUTHWEST 112TH TERRACE MIAMI, FL 33196 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $220 | $0 | $220 | 4.44% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTHCARE | 158 | $837K |
| Dental | AETNA LIFE INSURANCE COMPANY | 199 | $60K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 123 | $5K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 117 | $52K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 117 | $22K |
| Prescription drug | MVP HEALTHCARE | 158 | $837K |
| Other(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 117 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.