| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $91K | $3K | $95K | 5.77% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 1.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1K | $1K | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $2K | $11K | 14.93% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $3 | $7K | 10.47% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK INC. | 2122 KRATKY ROAD ST LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 9.31% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $139 | $0 | $139 | 0.21% |
| USI INSURANCE SERVICES LLC3 | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $815 | $0 | $815 | 2.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $582 | $0 | $582 | 1.72% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $140 | $4 | $144 | 15.38% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 143 | $2.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 143 | $1.6M |
| Vision | VISION SERVICE PLAN | 125 | $34K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 143 | $75K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 143 | $74K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 143 | $2.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 216 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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.