| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $49K | $983 | $50K | 3.11% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | STARMOUNT LIFE INSURANCE COMPANY | $11K | $3K | $13K | 13.28% |
| EBENEFITS MARKETPLACE LLC3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | STARMOUNT LIFE INSURANCE COMPANY | $126 | $0 | $126 | 0.13% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $2K | $12K | 21.91% |
| EBENEFITS MARKETPLACE LLC3 | 23 MAIDEN LANE NORTH HAVEN, CT 06473 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $939 | $0 | $939 | 1.78% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $796 | $0 | $796 | 1.51% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAMPAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $199 | $0 | $199 | 0.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $7K | $800 | $7K | 15.36% |
| EBENEFITS MARKETPLACE LLC3 | 204 STATE STREET NORTH HAVEN, CT 06473 | STANDARD INSURANCE COMPANY | $0 | $1K | $1K | 2.29% |
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 | 449 | 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) | 449 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 199 | $1.6M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 221 | $100K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 221 | $100K |
| Life insurance | STANDARD INSURANCE COMPANY | 449 | $49K |
| Prescription drug | MEDICA INSURANCE COMPANY | 199 | $1.6M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 449 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 449 | — |
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.