| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SW, INC. - DALLAS | P O BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $746 | $3 | $749 | 2.07% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AN AON CO | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | $497 | $503 | 1.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC. | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26 | — | $26 | 0.07% |
| JO ANN PANTALONE3 | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 9811 KATY FREEWAY STE 500 HOUSTON, TX 77024 | METLIFE LEGAL PLANS, INC. | $970 | — | $970 | 7.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI | P.O. BOX 840037 DALLAS, TX 752840037 | METLIFE LEGAL PLANS, INC. | — | $780 | $780 | 6.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS, INC. | $270 | — | $270 | 2.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS, INC. | — | $154 | $154 | 1.27% |
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 | 1,045 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,062 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 514 | $449K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 969 | $61K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,196 | $125K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 241 | $104K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 936 | $105K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,147 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,196 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.