| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DR STE 400 FALLS CHURCH, VA 22042 | CIGNA HEALTH & LIFE INSURANCE COMPANY | — | $96K | $96K | 3.49% |
| USI INSURANCE SERVICES LLC3 | 11350 MCCORMICK ROAD SUITE 1203 HUNT VALLEY, MD 21031 | HARTFORD LIFE AND ACCIDENT | $45K | $6K | $50K | 16.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST 801 S FIGUEROA STREET, STE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 0.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 4.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERICES LLC | 5455 RINGS ROAD STE 250, ATRIUM 2 S TOWER DUBLIN, OH 43017 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 10.96% |
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 | 298 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 214 | $2.8M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 229 | $108K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 214 | $2.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 294 | $298K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 294 | $298K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 294 | $298K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 298 | $312K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.