| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- NORTHEA | 180 PARK AVE SUITE 102 FLORHAM PARK, NJ 07932 | DELTA DENTAL | $10K | $0 | $10K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 8.64% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 13.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- NORTHEA | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 9.99% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.85% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $920 | $0 | $920 | 11.00% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 14.99% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $768 | $0 | $768 | 15.00% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $677 | $0 | $677 | 14.99% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $429 | $0 | $429 | 10.99% |
| THELMA JEAN CITTA3 | PO BOX 4353 CHERRY HILL, NJ 08034 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $212 | $0 | $212 | 9.15% |
| JILLETTA RILEY3 | 16 STERN PL FORDS, NJ 08863 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $60 | $0 | $60 | 2.59% |
| KARL M FRIEDMAN3 | PO BOX 4353 CHERRY HILL, NJ 08034 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $33 | $0 | $33 | 1.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62939 VIRGINIA BEACH, VA 23466 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $30 | $0 | $30 | 1.30% |
| MGW SERVICES LLC3 | 24301 MUIRLANDS BLVD, STE V330 LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $25 | $0 | $25 | 1.08% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $200 | $0 | $200 | 10.99% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $176 | $0 | $176 | 11.01% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $132 | $0 | $132 | 11.00% |
| USI INSURANCE SERVICES LLC3 | 601 UNION STREET SUITE 1000 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $155 | $0 | $155 | 14.99% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 171 | $99K |
| Vision | VISION SERVICE PLAN | 66 | $16K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 103 | $33K |
| Short-term disability(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 103 | $26K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 103 | $23K |
| Other(11 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 103 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.