| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 123 INTERSTATE DRIVE WEST SPRINGFIELD, MA 01089 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $215K | $0 | $215K | 2.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $3K | $3K | $6K | 1.62% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.46% |
| USI INSURANCE SERVICES LLC3 | 75 JOHN ROBERTS ROAD SOUTH PORTLAND, ME 04106 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 7.42% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 01801 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 4.80% |
| KATHLEEN E. GREEN3 | 123 INTERSTATE DRIVE WEST SPRINGFIELD, MA 01089 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.68% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $314 | $14 | $328 | 0.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $721 | $21 | $742 | 5.55% |
| USI INSURANCE SERVICES LLC3 | 12 GILL STREET, SUITE 5500 WOBURN, MA 18884 | FEDERAL INSURANCE COMPANY | $214 | $0 | $214 | 15.02% |
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 | 837 | 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) | 837 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,374 | $8.8M |
| Vision | VISION SERVICE PLAN | 531 | $113K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 837 | $351K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 36 | $33K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 837 | $351K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,374 | $8.8M |
| Other(6 contracts, 6 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,608 | $9.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,608 | — |
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.