| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 CHARLOTTE, NC 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $52K | $11K | $64K | 12.06% |
| USI INSURANCE SERVICES LLC3 | PO BOX 601478 CHARLOTTE, NC 28260 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | $0 | $14K | 4.58% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | KAISER FOUNDATION HEALTH PLAN, INC. | $744 | $0 | $744 | 0.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62889 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | $9K | $25K | 15.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 CHARLOTTE, NC 23466 | VISION SERVICE PLAN | $15K | $0 | $15K | 9.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | UNKNOWN CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $601 | $0 | $601 | 0.69% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD FIRE INSURANCE COMPANY | $0 | $1K | $1K | 20.76% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, SUITE 102 FLORHAM PARK, NJ 07932 | HARTFORD FIRE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
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 | 862 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 896 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 862 | $403K |
| Vision | VISION SERVICE PLAN | 733 | $145K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,207 | $527K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 548 | $159K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 37 | $316K |
| Other(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,207 | $669K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,207 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.