| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $517 | — | $517 | 4.14% |
| USI INSURANCE SERVICES LLC | 3190 FAIRVIEW PARK STE 400 FALLS CHURCH, VA 22042 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $174 | — | $174 | 1.39% |
| CUSTOM BENEFIT PROGRAMS INC Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH ST HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $57 | — | $57 | 3.75% |
| USI INSURANCE SERVICES LLC | 1750 H ST. NW STE 200 WASHINGTON, DC 20006 | FIRST UNUM LIFE INSURANCE COMPANY | $19 | — | $19 | 1.25% |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 741 | $356K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 625 | $40K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 50 | $14K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 50 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 741 | — |
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.