| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVCES LLC | 180 PARK AVE NJ, NJ 07932 | DELTA DENTAL OF PUERTO RICO INC | $3K | — | $3K | 2.95% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH | PO BOX 9023549 SAN JUAN, PR 00902 | DELTA DENTAL OF PUERTO RICO INC | $3K | — | $3K | 2.95% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE NJ, NJ 07932 | RELIANCE STANDARD LIFE INSURANCE | $562 | — | $562 | 4.49% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH SALDANA | PO BOX 9023549 SJ, PR 00902 | MCS LIFE INSURANCE COMPANY | $30K | — | $30K | — |
| INTERNATIONAL REINSURANCE MANAGERS3 | 7205 CORPORATE CENTER DRIVE SUITE 410 MIAMI, FL 33126 | MCS LIFE INSURANCE COMPANY | $20K | — | $20K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARSH SALDANA INC STOPLOSS | Other fees Service code 99 | PO BOX 9023549 SJ, PR 00902 | $0 |
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 | 330 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MCS LIFE INSURANCE COMPANY | 330 | $0 |
| Dental | DELTA DENTAL OF PUERTO RICO INC | 324 | $99K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE | 344 | $13K |
| Other | MCS LIFE INSURANCE COMPANY | 330 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 344 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.