| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 ATRIUM 2 SOUTH TOWER DUBLIN, OH 43017 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $33K | $33K | 1.32% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23K | $8K | $31K | 20.13% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | DELTA DENTAL OF OHIO | $9K | $0 | $9K | 8.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | — | $1K | 5.64% |
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 | 236 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 197 | $2.5M |
| Dental | DELTA DENTAL OF OHIO | 328 | $104K |
| Vision | VISION SERVICE PLAN | 193 | $19K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $153K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $153K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $153K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 197 | $2.5M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 229 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.