| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6300 BRIDGPOINT PKWY BLDG 3 STE 500 AUSTIN, TX 78730 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 3.65% |
| USI INSURANCE SERVICES LLC3 | 6300 BRIDGPOINT PKWY BLDG 3 STE 500 AUSTIN, TX 78730 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 2.36% |
| IMG3 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $80 | $80 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD, SUITE 100 ROCHESTER, NY 14623 | EXCELLUS BLUECROSS BLUESHIELD | $60K | — | $60K | 22.23% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 10.14% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD, SUITE 100 ROCHESTER, NY 14623 | EXCELLUS BLUECROSS BLUESHIELD | $975 | — | $975 | 4.12% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD, SUITE 100 ROCHESTER, NY 14623 | GUARDIAN | $5K | $712 | $5K | 28.25% |
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 | 354 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 240 | $295K |
| Dental | GUARDIAN | 281 | $19K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 356 | $25K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 354 | $525K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 354 | $525K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 354 | $525K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUECROSS BLUESHIELD | 240 | $271K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 354 | $525K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 356 | — |
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.