| 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 | $5K | $35K | $40K | 3.25% |
| USI INSURANCE SERVICES LLC3 | 201 ALHAMBRA CIRCLE, SUITE 1205 CORAL GABLES, FL 33134 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $0 | $9K | 3.28% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $5K | $0 | $5K | 2.98% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 11.31% |
| USI INSURANCE SERVICES LLC3 | 3805 WEST CHESTER PIKE, SUITE 200 NEWTOWN SQUARE, PA 19073 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $5K | $5K | 8.91% |
| PENTRA LLC3 Filed as: PENTRA, LLC | 795 EAST LANCANSTER AVENUE SUITE 210 VILLANOVA, PA 19085 | TRANSAMERICA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 22.66% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 5TH FLOOR NEW YORK, NY 10016 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 21.07% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | TRANSAMERICA LIFE INSURANCE COMPANY | $82 | $0 | $82 | 0.25% |
| RONALD M KLEIMAN3 Filed as: RONALD M. KLEIMAN | 4522 RFD LONG GROVE, IL 60047 | TRANSAMERICA LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FORT LAUDERDALE, FL 33308 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.88% |
| PENTRA LLC3 Filed as: PENTRA, LLC | 795 EAST LANCANSTER AVENUE SUITE 210 VILLANCVA, PA 19085 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 22.18% |
| USI INSURANCE SERVICES LLC3 | 201 ALHAMBRA CIRCLE, SUITE 801 CORAL GABLES, FL 33134 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.44% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFIT PROS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $177 | $0 | $177 | 1.30% |
| RONALD KLEIMAN3 | 4522 RFD LONG GROVE, IL 60047 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $142 | $0 | $142 | 1.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $75 | $75 | 0.55% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK, SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $32 | $32 | 0.23% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 20.00% |
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 | 4,602 | 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) | 4,602 | 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 | 246 | $1.7M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 246 | $1.7M |
| Vision(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 246 | $1.7M |
| Life insurance(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 4,602 | $534K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,602 | $85K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 4,602 | $52K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 246 | $1.7M |
| Other(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 4,602 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,602 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.