| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8540 COLONNADE CENTER DRIVE SUITE 111 RALEIGH, NC 27615 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $20K | $7K | $26K | 1.39% |
| LOCKTON COMPANIES, LLC3 | UNKNOWN BOSTON, MA 02129 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $15K | $0 | $15K | 0.81% |
| LOCKTON COMPANIES, LLC3 | 3 CITYPLACE DRIVE, SUITE 900 ST. LOUIS, MO 63141 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $387 | $18K | 6.96% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $5K | $18K | 6.90% |
| USI INSURANCE SERVICES LLC3 | 8540 COLONNADE CENTER DRIVE SUITE 111 RALEIGH, NC 27615 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $249 | $17K | 6.55% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.49% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $29 | $29 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 505115 ST. LOUIS, MO 63150 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 5.48% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | $0 | $1K | 2.49% |
| LOCKTON COMPANIES, LLC3 | PO BOX 505115 ST. LOUIS, MO 63150 | KAISER FOUNDATION HEALTH PLAN, INC. | $558 | $0 | $558 | 1.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $948 | $145 | $1K | 10.32% |
| LOCKTON COMPANIES, LLC3 | 15939 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | METLIFE LEGAL PLANS | $788 | $0 | $788 | 7.44% |
| SPETNER ASSOCIATES INC3 Filed as: SPETNER ASSOCIATES, INC. | UNKNOWN BOSTON, MA 02126 | COMBINED INSURANCE COMPANY | $1K | $0 | $1K | 23.28% |
| LOCKTON COMPANIES, LLC3 | UNKNOWN BOSTON, MA 02129 | COMBINED INSURANCE COMPANY | $669 | $0 | $669 | 11.51% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $8 | $3 | $11 | 7.91% |
| LOCKTON COMPANIES, LLC3 | 3 CITYPLACE DRIVE, SUITE 900 ST. LOUIS, MO 63141 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $9 | $0 | $9 | 6.47% |
| USI INSURANCE SERVICES LLC3 | 8540 COLONNADE CENTER DRIVE SUITE 111 RALEIGH, NC 27615 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $7 | $0 | $7 | 5.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $1 | $1 | 0.72% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $1 | $1 | 0.72% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $3 | $3 | $6 | 10.00% |
| USI INSURANCE SERVICES LLC3 | 8540 COLONNADE CENTER DRIVE SUITE 111 RALEIGH, NC 27615 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $4 | $0 | $4 | 6.67% |
| LOCKTON COMPANIES, LLC3 | 3 CITYPLACE DRIVE, SUITE 900 ST. LOUIS, MO 63141 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $2 | $0 | $2 | 3.33% |
| USI INSURANCE SERVICES LLC3 | 8540 COLONNADE CENTER DRIVE SUITE 111 RALEIGH, NC 27615 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $7 | $0 | $7 | — |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $0 | $1 | $1 | — |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $0 | $1 | $1 | — |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | -$1 | -$1 | -$2 | — |
| LOCKTON COMPANIES, LLC3 | 3 CITYPLACE DRIVE, SUITE 900 ST. LOUIS, MO 63141 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | -$9 | $0 | -$9 | — |
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 | 93 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 193 | $2.0M |
| Dental(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 206 | $255K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 206 | $255K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 206 | $261K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 206 | $255K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 206 | $255K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 193 | $2.0M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 206 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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.