| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $10K | $17K | 3.52% |
| LOCKTON COMPANIES, LLC3 | 1801 K STREET NW, SUITE 200 WASHINGTON, DC 20006 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 0.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | $3K | $25K | 5.63% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $1K | $20K | 4.54% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $936 | — | $936 | 0.21% |
| JO ANN PANTALONE3 | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $402 | — | $402 | 0.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 408 9TH STREET HUNTINGTON, WV 25701 | VISION SERVICE PLAN | $2K | — | $2K | 2.63% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | VISION SERVICE PLAN | $2K | — | $2K | 2.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | PO BOX 61007 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $750 | $6K | 23.64% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $319 | $573 | $892 | 3.28% |
| JO ANN PANTALONE3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $126 | — | $126 | 0.46% |
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 | 2,280 | 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) | 2,280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 688 | $473K |
| Vision | VISION SERVICE PLAN | 581 | $69K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,280 | $464K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,280 | $464K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,280 | $437K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,280 | $437K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,280 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.