| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203508 DALLAS, TX 75320 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $64K | $0 | $64K | 4.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203508 DALLAS, TX 75320 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $127K | $0 | $127K | 15.80% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 0.57% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 0.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203508 DALLAS, TX 75320 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $104K | $0 | $104K | 14.21% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $34K | $0 | $34K | 4.58% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $32K | $0 | $32K | 4.40% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $100K | $0 | $100K | 14.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $0 | $14K | 5.69% |
| USI INSURANCE SERVICES LLC3 | 100 NORTH MAIN STREET WINSTON SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $18K | $0 | $18K | 9.99% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.00% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.00% |
| USI INSURANCE SERVICES LLC4 | 100 NORTH MAIN STREET WINSTON SALEM, NC 27101 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 12.00% |
| STEVEN BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 5.00% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NE, INC. | 165 BROADWAY, 33RD FLOOR NEW YORK, NY 10006 | FEDERAL INSURANCE COMPANY | $1K | $0 | $1K | 19.99% |
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 | 1,892 | 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) | 1,892 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 517 | $1.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,892 | $2.1M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 1,781 | $180K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 892 | $1.5M |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 517 | $1.5M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 892 | $697K |
| Prescription drug(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 517 | $1.8M |
| Other(6 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,892 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,892 | — |
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.