| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 50 CABOT STREET, SUITE 2 NEEDHAM, MA 02494 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $170K | — | $170K | 2.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 5700 POST ROAD PO BOX 1158 EAST GREENWICH, RI 02818 | DELTA DENTAL OF RHODE ISLAND | $9K | — | $9K | 1.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $3K | $23K | 12.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | — | $2K | 2.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | FEDERAL INSURANCE COMPANY | $214 | $25 | $239 | 16.77% |
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 | 832 | 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) | 832 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,441 | $7.5M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 1,600 | $610K |
| Vision | VISION SERVICE PLAN | 591 | $81K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 832 | $178K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 832 | $178K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,441 | $7.5M |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,143 | $7.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,143 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.