| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 222 S. RIVERSIDE PLAZA STE. 900 CHICAGO, IL 60606 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 1.05% |
| USI INSURANCE SERVICES LLC3 | 222 S. RIVERSIDE PLAZA STE. 900 CHICAGO, IL 60606 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $475 | $43 | $518 | 2.22% |
| BERSON-SOKOL AGENCY INC3 Filed as: BERSON-SOKOL AGENCY INC. | PO BOX 22129 CLEVELAND, OH 44122 | UNUM LIFE INSURANCE CO. OF AMERICA | $644 | — | $644 | 21.25% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 141 | $142K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $23K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $23K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $23K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $23K |
| Long-term disability | UNUM LIFE INSURANCE CO. OF AMERICA | 59 | $3K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 141 | $142K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.