| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | WEST - SAN FRANCISCO PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 3.96% |
| USI INSURANCE SERVICES LLC3 | WEST - SAN FRANCISCO PO BOX 66119 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL ADVANTAGE ASSURANCE COMPANY EIN 45-5492167 NONE | Claims processing Service code 12 | — | $417K |
| INTEGRATED BEHAVIORAL HEALTH NONE | Claims processing Service code 12 | P.O. BOX 30018 LAGUNA NIGUEL, CA 92607 | $86K |
| PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 NONE | Claims processing Service code 12 | — | $73K |
| UNITED CONCORDIA EIN 25-1687586 NONE | Claims processing Service code 12 | — | $27K |
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 | 1,143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 84 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 544 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,771 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,614 | $501K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 455 | $191K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,140 | $230K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 1,073 | $358K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,614 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,614 | — |
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."
No prospect flags tripped on this filing.