| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFITS INSURANCE GROUP INC3 Filed as: CUSTOM BENEFITS INSURANCE GROUP | 897 12TH STREET HAMMONTON, NJ 08037 | COMBINED INSURANCE | $40K | — | $40K | 70.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 2502 N. ROCKY POINT DR. SUITE 400 TAMPA, FL 33607 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $199 | $5K | 38.44% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - TAMPA | 29840 NETWORK PLACE CHICAGO, IL 606731298 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $138 | -$28 | $110 | 0.86% |
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 | 1,552 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,559 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | FLORIDA BLUE | 1,552 | $4.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 589 | $200K |
| Vision(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 971 | $56K |
| Life insurance(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,552 | $187K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 344 | $204K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $64K |
| Other(4 contracts, 3 carriers) | COMBINED INSURANCE | 1,552 | $156K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,552 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.