| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES,LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $5K | — | $5K | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES,INC | 1900 N WINSTON RD, STE 100 KNOXVILLE, TN 37919 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $4K | — | $4K | 0.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $3K | — | $3K | 1.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES, INC | 1900 N WINSTON RD, STE 100 KNOXVILLE, TN 37919 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $1K | — | $1K | 0.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES,LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $2K | — | $2K | 1.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES,INC | 1900 N WINSTON RD, STE 100 KNOXVILLE, TN 37919 | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | $1K | — | $1K | 0.92% |
| WILLIAM THOMAS3 | 1900 N WINSTON RD, STE 100 KNOXVILLE, TN 37919 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $1K | — | $1K | 3.17% |
| KELLY ANDERSON3 | 950 BRECKENRIDGE LANE, STE 50 LOUISVILLE, KY 40207 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $1K | — | $1K | 3.07% |
| BENJAMIN DARANG3 Filed as: BENJAMIN KELLY | P.O. BOX 10328 KNOXVILLE, TN 37939 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $751 | — | $751 | 1.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES,LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 8.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES,INC | P.O. BOX 10328 KNOXVILLE, TN 37939 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | P.O. BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES,INC | P.O. BOX 10328 KNOXVILLE, TN 37939 | USABLE LIFE | $2K | — | $2K | 15.00% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES,INC | 1 CAMERON HILL CIRCLE 2.5 CHATTANOOGA, TN 37402 | USABLE LIFE | $878 | $318 | $1K | 7.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 8.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES, INC | P.O. BOX 10328 KNOXVILLE, TN 37939 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $849 | — | $849 | 6.48% |
| USI INSURANCE SERVICES LLC Filed as: USI MIDWEST INC | P.O. BOX 3176 NORFOLK, VA 23514 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $703 | $703 | 5.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES,LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $490 | — | $490 | 4.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES,INC | P.O. BOX 10328 KNOXVILLE, TN 37939 | EYEMED VISION CARE | $279 | — | $279 | 2.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES,LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE | $109 | — | $109 | 0.99% |
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 | 220 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | 126 | $725K |
| Dental | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 186 | $42K |
| Vision | EYEMED VISION CARE | 135 | $11K |
| Life insurance | USABLE LIFE | 127 | $16K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $32K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $13K |
| Other | USABLE LIFE | 127 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.