| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 312 ELM ST CINCINNATI, OH 45202 | AETNA LIFE INSURANCE CO. | $7K | — | $7K | 0.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $1K | $11K | 11.33% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $504 | $6K | 16.30% |
| USI INSURANCE SERVICES LLC3 | 7 E CONGRESS ST STE 1002 SAVANNAH, GA 314013396 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $57 | $57 | 0.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-OH | PO BOX 62689 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $2K | — | $2K | 11.33% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION-EXCHANGE | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 142042265 | EYEMED VISION CARE | $893 | — | $893 | 5.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $169 | $2K | 15.82% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $452 | $452 | 4.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | METROPOLITAN LIFE INSURANCE COMPANY | $888 | $130 | $1K | 16.34% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $296 | $296 | 4.75% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | METROPOLITAN LIFE INSURANCE COMPANY | $867 | $129 | $996 | 16.39% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $289 | $289 | 4.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-OH | PO BOX 62689 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $509 | — | $509 | 10.99% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION-EXCHANGE | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 14204 | EYEMED VISION CARE | $254 | — | $254 | 5.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-OH | PO BOX 62689 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $11 | — | $11 | 20.37% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION-EXCHANGE | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 14204 | EYEMED VISION CARE | $5 | — | $5 | 9.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-OH | PO BOX 62689 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $2 | — | $2 | 18.18% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION-EXCHANGE | 199 SCOTT ST, FLOOR 8 BUFFALO, NY 14204 | EYEMED VISION CARE | $1 | — | $1 | 9.09% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 167 | $895K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 145 | $93K |
| Vision(4 contracts) | EYEMED VISION CARE | 132 | $20K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $129K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $36K |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.