| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADAMS BENEFIT CORPORATION3 | 600 CORPORATE DRIVE, SUITE 305 FORT LAUDERDALE, FL 33334 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $525K | $24K | $549K | 11.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62946 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $30K | — | $30K | 1.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | WORLD TRADE CENTER MAIN STREET, SUITE 900 NORFOLK, VA 23510 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $37K | $6K | $42K | 2.90% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $32K | -$23 | $32K | 2.85% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $5K | $20K | 1.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15K | — | $15K | 1.33% |
| JO ANN PANTALONE3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $820 | — | $820 | 0.07% |
| DAVID ADAMS3 Filed as: DAVID B. ADAMS | 1395 LANDS END ROAD LANTANA, FL 33462 | RELIASTAR LIFE INSURANCE COMPANY | $165K | — | $165K | 27.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 WEST CYPRUS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | LEGAL | $38K | — | $38K | 40.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 WEST CYPRUS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $17 | $5K | 12.49% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $97 | — | $97 | 3.49% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 1.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 WEST CYPRESS CREEK ROAD SUITE 500 FORT LAUDERDALE, FL 33309 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.18% |
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 | 11,027 | 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) | 11,027 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 566 | $3.9M |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 11,027 | $6.6M |
| Short-term disability(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 11,027 | $6.0M |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 11,027 | $4.9M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 566 | $3.9M |
| Other(7 contracts, 6 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 11,027 | $6.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,027 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.