| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 201629 DALLAS, TX 75320 | HUMANA MEDICAL PLAN, INC. | $37K | $0 | $37K | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203383 DALLAS, TX 75320 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | $0 | $19K | 9.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $2K | $15K | 11.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS INC., A FLORIDA CORPORATION | $3K | $519 | $4K | 11.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | ADVANTICA INSURANCE COMPANY | $3K | $0 | $3K | 8.95% |
| WELLS FARGO INSURANCE SERVICES3 | ONE NORTH JEFFERSON BUILDING C-3 SAINT LOUIS, MO 63103 | ADVANTICA INSURANCE COMPANY | $937 | $0 | $937 | 3.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 14.53% |
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 | 814 | 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) | 814 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA MEDICAL PLAN, INC. | 458 | $3.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $163K |
| Vision | ADVANTICA INSURANCE COMPANY | 475 | $31K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 814 | $198K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 814 | $198K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 814 | $198K |
| Prescription drug | HUMANA MEDICAL PLAN, INC. | 458 | $3.7M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 814 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 814 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.