| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62819 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $5K | $21K | 8.56% |
| PROGRESSIVE BENEFIT SOLUT3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 3.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62819 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $3K | $9K | 5.32% |
| PROGRESSIVE BENEFIT SOLUT3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, MA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 1.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62819 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $3K | $13K | 8.62% |
| PROGRESSIVE BENEFIT SOLUT3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 3.35% |
| USI INSURANCE SERVICES LLC3 | 310 1ST ST SW STE 1250 ROANOKE, VA 24011 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $675 | $0 | $675 | 2.25% |
| EMPLOYEE FAMILY PROTECTION INC3 | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $247 | $0 | $247 | 0.82% |
| DARRELL E. DAVIS AND ASSOCIATES INC3 Filed as: DARRELL E DAVIS AND ASSOCIATES INC | PO BOX 1596 KERNERSVILLE, NC 27285 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.14% |
| COUSINS MICHAEL L3 Filed as: COUSINS, MICHAEL, LYNN | P O BOX 327 GARNER, NC 27529 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.08% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES INC | PO BOX 327 GARNER, NC 27529 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62819 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $217 | $143 | $360 | 5.97% |
| PROGRESSIVE BENEFIT SOLUT3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $85 | $0 | $85 | 1.41% |
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 | 660 | 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) | 660 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 309 | $200K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 453 | $275K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 630 | $146K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 599 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 630 | — |
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.