| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 235 MAGRATH DARBY BLVD MT PLEASANT, SC 29464 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 3.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 1.44% |
| IMG5 | 2960 NORTH MERIDAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD, SUITE 100 ROCHESTER, NY 14623 | EXCELLUS BLUECROSS BLUESHIELD | $63K | — | $63K | 19.63% |
| USI INSURANCE SERVICES LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 9.89% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD, SUITE 100 ROCHESTER, NY 14623 | EXCELLUS BLUECROSS BLUESHIELD | $1K | — | $1K | 4.86% |
| USI INSURANCE SERVICES LLC3 | 777 CANAL VIEW BLVD, SUITE 100 ROCHESTER, NY 14623 | GUARDIAN | $6K | $1K | $7K | 30.20% |
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 | 424 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | EXCELLUS BLUECROSS BLUESHIELD | 289 | $348K |
| Dental | GUARDIAN | 333 | $24K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 428 | $28K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $528K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $528K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $528K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 1 | $25K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUECROSS BLUESHIELD | 289 | $323K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 424 | $528K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 428 | — |
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.