| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $9K | — | $9K | 6.60% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 0.82% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | — | $11K | 7.83% |
| BENEFIT CONTROLS OF THE MIDLANDS3 Filed as: BENEFIT CONTROLS OF SC, INC. | 109 LAURENS ROAD BUILDING 3 GREENVILLE, SC 29607 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $3K | $3K | 1.94% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 1.49% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.98% |
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 | 188 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 448 | $142K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 498 | $18K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $138K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $138K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $138K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 498 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.