| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $35K | $37K | 2.35% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1900 MACARTHUR BOULEVARD PENTHOUSE SUITE IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $671 | $10K | $10K | 0.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2400 EAST COMMERCIAL BOULEVARD SUITE 600 FORT LAUDERDALE, FL 33308 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 7.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 408 9TH STREET HUNTINGTON, WV 25701 | VISION SERVICE PLAN | $1K | — | $1K | 7.75% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | EPIC OPERATING FILE 1367 PASADENA, CA 91199 | VISION SERVICE PLAN | $311 | — | $311 | 2.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3190 FAIRVIEW PARK DRIVE SUITE 400 FALLS CHURCH, VA 22042 | INOVA EMPLOYEE ASSISTANCE | $123 | — | $123 | 5.34% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 131 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 131 | $1.6M |
| Vision | VISION SERVICE PLAN | 106 | $14K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 143 | $150K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 143 | $150K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 143 | $150K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 131 | $1.6M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 143 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.