| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 95 GLASTONBURY BLVD., SUITE 102 GLASTONBURY, CT 06033 | DELTA DENTAL OF NJ INC | $6K | — | $6K | 2.98% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVE, PO BOX 1040 MERIDEN, CT 064504893 | VISION SERVICE PLAN | $2K | — | $2K | 3.99% |
| USI INSURANCE SERVICES LLC4 | 475 KILVERT ST, BLDG B, STE 205 WARWICK, RI 05403 | VISION SERVICE PLAN | $71 | — | $71 | 0.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 3716 NORFOLK, VA 235143716 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.00% |
| BOSTON OPCO3 | PO BOX 62937 VIRGINIA BEACH, VA 234662937 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.33% |
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 | 326 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 265 | $3.5M |
| Dental | DELTA DENTAL OF NJ INC | 319 | $200K |
| Vision | VISION SERVICE PLAN | 258 | $38K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 326 | $37K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 265 | $3.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 326 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.