| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD ILLINOIS | $116 | $5K | $5K | 0.10% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $47K | $24K | $70K | 14.62% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | PO BOX 6718 SOMERSET, NJ 08875 | HARTFORD LIFE AND ACCIDENT | $14K | $0 | $14K | 2.87% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | HARTFORD LIFE AND ACCIDENT | $6K | $550 | $6K | 1.33% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | PO BOX 955816 ST. LOUIS, MO 63195 | HARTFORD LIFE AND ACCIDENT | $0 | $204 | $204 | 0.04% |
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $70 | $25K | 10.97% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.84% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.46% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $17 | $17 | 0.01% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | -$29 | -$4 | -$33 | -0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | -$3 | $0 | -$3 | -0.01% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | LEGALPLANS, USA | $2K | $0 | $2K | 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 | 526 | 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) | 526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD ILLINOIS | 738 | $5.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 850 | $232K |
| Vision | VISION SERVICE PLAN | 434 | $44K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 526 | $480K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 526 | $480K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 526 | $480K |
| Prescription drug | BLUECROSS BLUESHIELD ILLINOIS | 738 | $5.0M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 526 | $495K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 850 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.