| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES CORPORATION | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | $0 | $7K | 2.46% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | UNKNOWN PASADENA, CA 90017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $34 | $6K | $6K | 2.14% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $83 | $83 | 0.09% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 843844 KANSAS CITY, MO 64184 | METROPOLITAN LIFE INSURANCE COMPANY | — | -$975 | -$975 | -1.06% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $208 | $0 | $208 | 0.40% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $903 | $0 | $903 | 14.95% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $0 | $1K | 20.00% |
| USI INSURANCE SERVICES LLC3 | 2001 SPRING RD STE 200 OAK BROOK, IL 60523 | FEDERAL INSURANCE COMPANY | $491 | $98 | $589 | 17.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SIKICH CPA LLC EIN 54-1172176 PLAN AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $48K |
| GSA NATIONAL EIN 11-3335620 THIRD PARTY ADMINISTRATO | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $43K |
| CIGNA EIN 59-1031071 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | — | $42K |
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 | 212 | 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) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 259 | $92K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 244 | $302K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 216 | $52K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 216 | $52K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 244 | $302K |
| Other(5 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 216 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.