| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 2400 E COMMERCIAL BLVD #600 FT LAUDERDALE, FL 333084050 | HUMANA HEALTH PLAN, INC. | $22K | $0 | $22K | 3.84% |
| JACQUELINE S ELLER3 | PO BOX 46510 DENVER, CO 802016510 | HUMANA HEALTH PLAN, INC. | -$5K | $0 | -$5K | -0.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 261 MADISON AVE STE 6A NEW YORK, NY 100162314 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $0 | $7K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT RD NE #800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 234662819 | VISION SERVICE PLAN | $875 | $0 | $875 | 4.78% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT RD NE #800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT RD NE #800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $877 | $0 | $877 | 10.00% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT RD NE #800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $870 | $0 | $870 | 10.00% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT RD NE #800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $830 | $0 | $830 | 10.00% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT RD NE #800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $443 | $0 | $443 | 10.00% |
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 | 355 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLAN, INC. | 401 | $578K |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 851 | $68K |
| Vision | VISION SERVICE PLAN | 357 | $18K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 235 | $13K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $23K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 90 | $34K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 197 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 851 | — |
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.