| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203066 DALLAS, TX 75320 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $69K | $0 | $69K | 3.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $60 | $16K | 9.60% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $8K | $8K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.46% |
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.56% |
| 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% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 3.44% |
| USI INSURANCE SERVICES LLC3 | 190 RIVER ROAD SUMMIT, NJ 07901 | COMPANION LIFE INSURANCE COMPANY | $299 | $0 | $299 | 6.13% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE COMPANY | $189 | $0 | $189 | 3.87% |
| USI INSURANCE SERVICES LLC3 | 213 SOUTH JEFFERSON STREET SW ROANOKE, VA 24011 | ANTHEM LIFE AND DISABILITY INSURANCE COMPANY | $261 | $0 | $261 | 14.78% |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 189 | $2.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 151 | $170K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $37K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 173 | $177K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 151 | $170K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 151 | $170K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 189 | $2.0M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 151 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.