| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3427 NORFOLK, VA 23514 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 1.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23246 | AETNA LIFE INSURANCE COMPANY | $399 | — | $399 | 0.22% |
| EMERSON REID LLC3 Filed as: EMERSON REID, LLC | 630 WEST GERMANTOWN PIKE, SUITE 215 PLYMOUTH MEETING, PA 19462 | AETNA LIFE INSURANCE COMPANY | — | $221 | $221 | 0.12% |
| EMERSON REID LLC3 Filed as: EMERSON REID , LLC | 401 BROADWAY, SUITE 912 NEW YORK, NY 10013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $179 | — | $179 | 3.85% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $54 | $59 | 1.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.62% |
| CONNER STRONG & BUCKELEW3 Filed as: CONNOR STRONG AND BUCKELEW | 401 ROUTE 73 NORTH MARLTON, NJ 08053 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.43% |
| ROY B. PORTNER3 | 631 FORREST AVENUE JENKINTOWN, PA 19382 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.37% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AND OTHER AGENT | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.04% |
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 | 550 | 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) | 550 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 473 | $184K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 473 | $188K |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 473 | $188K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 473 | $184K |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 550 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 550 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.