| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE COMPANY | $5K | $1K | $6K | 21.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $1K | $3K | 13.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $424 | $0 | $424 | 2.89% |
| USI INSURANCE SERVICES LLC3 | 75 JOHN ROVERTS ROAD, BUILDING C SOUTH PORTLAND, ME 04108 | THE PAUL REVERE LIFE INSURANCE COMPANY | $531 | $0 | $531 | 3.92% |
| BMB BENEFITS GROUP INC3 | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $355 | $0 | $355 | 2.62% |
| DONALD H MATSON3 | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $150 | $0 | $150 | 1.11% |
| LORRAINE RHODES3 | 4A KENSINGTON COURT CLIFTON PARK, NY 12065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $148 | $0 | $148 | 1.09% |
| SINGLE POINT ENROLLMENT SOLUTIONS3 | 14716 SW 112TH TER MIAMI, FL 33196 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 140 | $15K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 119 | $28K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 119 | $26K |
| Other(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 119 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.