| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 190 RIVER ROAD, SUITE 101 SUMITT, NJ 07901 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $44K | $0 | $44K | 3.50% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | OXFORD HEALTH INSURANCE, INC | $10K | $0 | $10K | 2.22% |
| FRED MANAS3 | 451 50TH STREET, 1ST FLOOR BROOKLYN, NY 11220 | OXFORD HEALTH INSURANCE, INC | $10K | $0 | $10K | 2.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $60 | $11K | 7.98% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 5.00% |
| FRED MANAS3 | 451 50TH STREET BROOKLYN, NY 11220 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.36% |
| USI INSURANCE SERVICES LLC3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.29% |
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 7.29% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.00% |
| FRED MANAS3 | 451 50TH STREET, SUITE LL1 BROOKLYN, NY 11220 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $967 | $0 | $967 | 2.71% |
| NATIONAL FINANCIAL NETWORK, LLC3 | 7 HANOVER SQUARE, SUITE 8A 8TH FLOOR NEW YORK, NY 10004 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $37 | $0 | $37 | 0.10% |
| FRED MANAS3 | 451 50TH STREET BROOKLYN, NY 11220 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.31% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.21% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET BUFFALO, NY 14204 | PRINCIPAL LIFE INSURANCE COMPANY | $970 | $0 | $970 | 5.18% |
| JOSEPH GATTI3 | PO BOX 755 ORADELL, NJ 07649 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $644 | $0 | $644 | 6.06% |
| USI INSURANCE SERVICES LLC3 | 213 SOUTH JEFFERSON STREET ROANOKE, VA 24011 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $268 | $0 | $268 | 2.52% |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 145 | $135K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 100 | $36K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 145 | $164K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 145 | $153K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 145 | $153K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $1.7M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 145 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.