| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $0 | $42K | $42K | 1.86% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | AETNA LIFE INSURANCE COMPANY | $0 | $36K | $36K | 1.61% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $4K | $4K | 5.37% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 2.27% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE NEW YORK, NY 10016 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $0 | $1K | 1.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $9K | $4K | $13K | 17.87% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $0 | $2K | 3.18% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.11% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | COMPANION LIFE INSURANCE COMPANY | $540 | $0 | $540 | 1.27% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 250 PEHLE AVENUE, SUITE 400 PARK 80 WEST, PLAZA 2 SADDLE BROOK, NJ 07663 | VISION SERVICE PLAN | $714 | $0 | $714 | 4.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $482 | $0 | $482 | 2.72% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 264 | $2.2M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 232 | $84K |
| Vision | VISION SERVICE PLAN | 98 | $18K |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 174 | $116K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 174 | $74K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 174 | $74K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 264 | $2.2M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 174 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.