| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8360 WEST SAHARA AVENUE, SUITE 110 LAS VEGAS, NV 89117 | PROMINENCE HEALTH PLAN | $19K | $0 | $19K | 2.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $0 | $7K | 8.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | PREMIER ACCESS INSURANCE COMPANY | $3K | $0 | $3K | 4.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62757 VIRGINIA BEACH, VA 23466 | HM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: CRAGIN AND PIKE, INC. | 10000 WEST CHARLESTON BOULVARD SUITE 200 LAS VEGAS, NV 89135 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $0 | $36 | 4.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.60% |
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 | 198 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROMINENCE HEALTH PLAN | 347 | $955K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 365 | $62K |
| Vision | HM LIFE INSURANCE COMPANY | 210 | $13K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 343 | $83K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 343 | $82K |
| Prescription drug | PROMINENCE HEALTH PLAN | 347 | $955K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 343 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.