| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 1.51% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1014 VINE STREET, SUITE 1100 CINCINNATI, OH 45202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $6K | $6K | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1014 VINE STREET, SUITE 1100 CINCINNATI, OH 45202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $6K | $23K | 24.22% |
| PLANSOURCE BENEFIT ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRAT | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 3.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1014 VINE STREET, SUITE 1100 CINCINNATI, OH 45202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $448 | $2K | 3.86% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $301 | $299 | $600 | 1.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3499 YOUNGSTOWN, OH 44513 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $551 | $0 | $551 | 1.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1301 EAST 9TH STREET, SUITE 3800 CLEVELAND, OH 44114 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $0 | $123 | 0.24% |
| SUSAN S VERSCHOOR3 | 1 MONTGOMERY STREET SAN FRANCISCO, CA 94104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.07% |
| PHILIP N. MCKELVEY3 Filed as: PHILIP NEILL MCKELVEY | 600 WEST LOVELAND AVENUE LOVELAND, OH 45140 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
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 | 751 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 760 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 817 | $483K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 817 | $483K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 817 | $431K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 817 | $577K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 817 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.