| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 600 3RD AVENUE, FORNT 3 NEW YORK, NY 10016 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $83 | $12K | 1.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | $8K | $20K | $28K | 8.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $3K | $0 | $3K | 4.21% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS LLC | PO BOX 746600 ATLANTA, GA 30374 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 16.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV, LLC | PO BOX 746600 ATLANTA, GA 30374 | METLIFE LEGAL PLANS | $253 | $0 | $253 | 1.76% |
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 | 609 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 632 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 45 | $795K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $923K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 942 | $73K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $923K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $923K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $923K |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 944 | $956K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 944 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.