| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $61K | $65K | 4.91% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $3K | $3K | 0.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $0 | $8K | 2.49% |
| USI INSURANCE SERVICES LLC3 | 201 ALHAMBRA CIRCLE, SUITE 1205 CORAL GABLES, FL 33134 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | $0 | $6K | 2.04% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $6K | $0 | $6K | 2.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | $0 | $17K | 10.65% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $9K | $9K | 5.95% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, SUITE 500 NEW YORK, NY 10016 | TRANSAMERICA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 34.74% |
| PENTRA LLC3 Filed as: PENTRA, LLC | 1041 OLD CASSATT ROAD BERWYN, PA 19312 | TRANSAMERICA LIFE INSURANCE COMPANY | $308 | $0 | $308 | 1.41% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | TRANSAMERICA LIFE INSURANCE COMPANY | $84 | $0 | $84 | 0.38% |
| USI INSURANCE SERVICES LLC3 | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FT LAUDERDALE, FL 33308 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.98% |
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 | 1,032 | 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) | 1,032 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 195 | $1.9M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 195 | $1.8M |
| Vision(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 195 | $1.8M |
| Life insurance(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,032 | $704K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,032 | $179K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,032 | $157K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 195 | $1.8M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,032 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,032 | — |
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.