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  5. USI INSURANCE SERVICES LLC

USI INSURANCE SERVICES LLC

Company Details

Name: USI INSURANCE SERVICES LLC
Jurisdiction: New York
Legal type: FOREIGN LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 09 Nov 2007 (17 years ago)
Entity Number: 3591600
ZIP code: 10005
County: Westchester
Place of Formation: Delaware
Address: 28 LIBERTY STREET, NEW YORK, NY, United States, 10005

Contact Details

Phone +1 212-842-3432

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
USI 401(K) PLAN 2023 133771734 2024-10-09 USI INSURANCE SERVICES LLC 11875
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 10251
Retired or separated participants receiving benefits 96
Other retired or separated participants entitled to future benefits 2498
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 13
Number of participants with account balances as of the end of the plan year 12390
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 969

Signature of
Role Plan administrator
Date 2024-10-09
Name of individual signing LENA OTTUSCH
Valid signature Filed with authorized/valid electronic signature
HOOKER & HOLCOMBE, INC PENSION PLAN 2023 133771734 2024-10-09 USI INSURANCE SERVICES, LLC 83
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1974-01-01
Business code 525100
Sponsor’s telephone number 8772724874
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Signature of
Role Plan administrator
Date 2024-10-09
Name of individual signing NORMAN E. YAMAMOTO
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2022 133771734 2023-10-11 USI INSURANCE SERVICES LLC 11719
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 9397
Retired or separated participants receiving benefits 68
Other retired or separated participants entitled to future benefits 2397
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 13
Number of participants with account balances as of the end of the plan year 11338
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 238

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing LENA OTTUSCH
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2021 133771734 2022-10-17 USI INSURANCE SERVICES, LLC 11195
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 8186
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3528
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 5
Number of participants with account balances as of the end of the plan year 11529
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 891

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing LENA OTTUSCH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-17
Name of individual signing LENA OTTUSCH
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2020 133771734 2021-10-15 USI INSURANCE SERVICES, LLC 10202
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 8081
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3036
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 4
Number of participants with account balances as of the end of the plan year 10898
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 535

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing LENA OTTUSCH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-15
Name of individual signing LENA OTTUSCH
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2019 133771734 2020-10-15 USI INSURANCE SERVICES, LLC 9504
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 7233
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2858
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 4
Number of participants with account balances as of the end of the plan year 9867
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 857

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-15
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2018 133771734 2019-10-15 USI INSURANCE SERVICES, LLC 8770
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 7251
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2169
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 7
Number of participants with account balances as of the end of the plan year 699
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 458

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-15
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2017 133771734 2018-10-15 USI INSURANCE SERVICES, LLC 5745
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 7060
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1633
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 5
Number of participants with account balances as of the end of the plan year 8154
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 540

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2016 133771734 2017-10-11 USI INSURANCE SERVICES, LLC 6460
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595
Plan sponsor’s address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 4262
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1400
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 6
Number of participants with account balances as of the end of the plan year 5427
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 424

Signature of
Role Plan administrator
Date 2017-10-11
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-11
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
USI 401(K) PLAN 2015 133771734 2016-10-13 USI INSURANCE SERVICES, LLC 6707
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 525100
Sponsor’s telephone number 9147498500
Plan sponsor’s mailing address 200 SUMMIT LAKE DRIVE, SUITE 350, VALHALLA, NY, 10595
Plan sponsor’s address 200 SUMMIT LAKE DRIVE, SUITE 350, VALHALLA, NY, 10595

Number of participants as of the end of the plan year
Active participants 5256
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1166
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 3
Number of participants with account balances as of the end of the plan year 5394
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 271

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-13
Name of individual signing KIM VAN ORMAN
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
C/O CT CORPORATION SYSTEM DOS Process Agent 28 LIBERTY STREET, NEW YORK, NY, United States, 10005

Agent

Name Role Address
CT CORPORATION SYSTEM Agent 28 LIBERTY STREET, NEW YORK, NY, 10005

History

Start date End date Type Value
2023-06-17 2023-11-01 Address 28 LIBERTY STREET, NEW YORK, NY, 10005, USA (Type of address: Service of Process)
2023-06-17 2023-11-01 Address 28 LIBERTY STREET, NEW YORK, NY, 10005, USA (Type of address: Registered Agent)
2019-11-20 2023-06-17 Address 28 LIBERTY STREET, NEW YORK, NY, 10005, USA (Type of address: Registered Agent)
2019-11-20 2023-06-17 Address 28 LIBERTY STREET, NEW YORK, NY, 10005, USA (Type of address: Service of Process)
2019-11-18 2019-11-20 Address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595, USA (Type of address: Service of Process)
2018-05-07 2019-11-18 Address 100 SUMMIT DRIVE, SUITE 400, VALHALLA, NY, 10595, USA (Type of address: Service of Process)
2018-01-25 2018-05-07 Address 100 SUMMIT LAKE DRIVE, SUITE 400, VALHALLA, NY, 10595, USA (Type of address: Service of Process)
2013-12-04 2018-01-25 Address 200 SUMMIT LAKE DRIVE, VALHALLA, NY, 10595, USA (Type of address: Service of Process)
2009-09-30 2013-12-04 Address 555 PLEASANTVILLE ROAD, SUITE 160 SOUTH, BRIARCLIFF MANOR, NY, 10510, USA (Type of address: Service of Process)
2009-09-29 2009-09-30 Address 555 PLEASANTVILLE ROAD, SUITE 160 SOUTH, BRIARCLIFF MANOR, NY, 10510, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
231101041899 2023-11-01 BIENNIAL STATEMENT 2023-11-01
230617000820 2023-06-16 CERTIFICATE OF PUBLICATION 2023-06-16
211101004294 2021-11-01 BIENNIAL STATEMENT 2021-11-01
191120000538 2019-11-20 CERTIFICATE OF CHANGE 2019-11-20
191118060474 2019-11-18 BIENNIAL STATEMENT 2019-11-01
180507000454 2018-05-07 CERTIFICATE OF MERGER 2018-05-07
180125006172 2018-01-25 BIENNIAL STATEMENT 2017-11-01
151203006570 2015-12-03 BIENNIAL STATEMENT 2015-11-01
131204006168 2013-12-04 BIENNIAL STATEMENT 2013-11-01
111129002759 2011-11-29 BIENNIAL STATEMENT 2011-11-01

Related by officers

C/O CT CORPORATION SYSTEM

1 MILL ROAD APARTMENTS INVESTORS RHPI, LLC 100 CHURCH STREET TENANT, LLC MEASURE UP, INC. 197 BLEECKER STREET LLC 228 SUNSET LLC 2SM DEVELOPMENT, LLC 3 EXECUTIVE ODELL MANAGING CO. GP, LLC 303 WINDING ROAD OWNER LLC LAKE SUCCESS (NY) SNYDER LEATHER OUTLET, INC. 3400 NEW HYDE PARK DEVELOPERS, LLC

CT CORPORATION SYSTEM

LECNET, INC. SW GAMING, LLC 100 CHURCH STREET TENANT, LLC BENNETT JONES SERVICES (US) INC. 106 OLD DEPOT ROAD LLC CORNERSTONE UNITED, INC. FURNISHINGS SYSTEMS (U.S.), INC. 125 KENNEDY H, LLC LIBERTY SUBACUTE MANAGEMENT CORP.

Related by address

28 LIBERTY STREET, NEW YORK, NY, United States, 10005

+42 W 35TH HOLDINGS LLC 0511 BLUM CHARLTON, LLC 1 BAY BLVD HOLDINGS, LLC 1 DANIEL LORD ROAD LLC 1 DEARBORN TACOS LLC 1 HOTEL BROOKLYN BRIDGE, L.L.C. 1 HOTEL CENTRAL PARK, L.L.C. 1 KAKIAT COURT LLC 1 MILL ROAD APARTMENTS INVESTORS RHPI, LLC 1 RAYMOND ST LLC

Date of last update: 04 Feb 2025

Sources: New York Secretary of State

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