| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $60K | $60K | 1.85% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $50K | $50K | 1.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $26K | $1K | $27K | 10.76% |
| LIAZON BENEFITS INC5 | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $13K | $13K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.56% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 14.83% |
| LIAZON BENEFITS INC5 | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE COMPANY | $1K | $587 | $2K | 15.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $322 | $157 | $479 | 14.89% |
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 | 233 | 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) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 332 | $3.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 166 | $253K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 204 | $49K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $268K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 166 | $253K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 166 | $253K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 332 | $3.3M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.