| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62819 VIRGINIA BEACH, VA 234662819 | RELIASTAR LIFE INSURANCE COMPANY | $45K | — | $45K | 13.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 SUMMIT LAKE DR STE 400 VALHALLA, NY 105951362 | RELIASTAR LIFE INSURANCE COMPANY | $15K | — | $15K | 4.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 8.25% |
| JAMES A SCOTT & SON INC3 | P.O. BOX 603438 CHARLOTTE, NC 28260 | METROPOLITAN LIFE INSURANCE COMPANY | $755 | — | $755 | 2.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC EIN 36-4197088 CLAIMS ADMINISTRATION | Contract Administrator; Claims processing Service code 12 | 18861 90TH AVENUE, STE. A MOKENA, IL 60448 | $205K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMINISTRATION | Claims processing; Participant communication; Float revenue; Named fiduciary; Other services; Direct payment from the plan; Non-monetary compensation; Contract Administrator Service code 12 | — | $24K |
| RXBENEFITS, INC EIN 63-1157085 CLAIMS ADMINISTRATION | Contract Administrator Service code 13 | 3700 COLONNADE PKWY, STE 600 BIRMINGHAM, AL 35243 | $5K |
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 | 620 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 624 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 463 | $35K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 789 | $332K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 789 | $332K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 789 | $332K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 789 | $332K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 789 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.