| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 470 PARK AVE SOUTH FLOOR 6 NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | — | $15K | $15K | 2.27% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCS INC | PO BOX 91147 SIOUX FALLS, SD 571091147 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 0.55% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCS INC | PO BOX 91147 SIOUX FALLS, SD 571091147 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEWST | THREE MEMORIAL PLAZA 840 GESSNER STE 600 HOUSTON, TX 77024 | FOUR EVER LIFE INS. CO. | $1K | — | $1K | 15.00% |
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 | 1,517 | 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) | 1,534 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,517 | $41K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2 | $33K |
| Vision(4 contracts) | EYEMED VISION CARE | 1,540 | $170K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,517 | $707K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,517 | $700K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,517 | $700K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,540 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.