| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $27K | $27K | 2.24% |
| USI INSURANCE SERVICES LLC3 | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $16K | $0 | $16K | 1.34% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DR ST 350 VALHALLA, NY 10595 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $8K | $8K | 2.49% |
| USI INSURANCE SERVICES LLC3 | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $5K | $5K | 2.39% |
| USI INSURANCE SERVICES LLC3 | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.62% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DR ST 350 VALHALLA, NY 10595 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $17K | $0 | $17K | 15.02% |
| USI INSURANCE SERVICES LLC3 | 600 THIRD AVENUE, 3RD FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND CASUALTY INSURANCE | $6K | $5 | $6K | 10.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND CASUALTY INSURANCE | $0 | $2K | $2K | 3.00% |
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 | 1,371 | 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) | 1,371 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 1,382 | $1.2M |
| Short-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 1,382 | $1.5M |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 1,382 | $1.2M |
| Other(4 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 1,382 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,382 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.