| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | $47K | $153 | $47K | 3.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | COMMUNITY INSURANCE COMPANY | $23K | — | $23K | 1.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 300 EAST MAIN STREET, SUITE 1300 NORFOLK, VA 23510 | DELTA DENTAL OF OHIO | $8K | — | $8K | 7.56% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 12.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE COMPANY, LLC | 300 EAST MAIN STREET, SUITE 1300 NORFOLK, VA 23510 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $857 | — | $857 | 2.47% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $310 | $310 | 0.89% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 3247 WEST MARCH LANE STOCKTON, CA 95219 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3247 WEST MARCH LANE STOCKTON, CA 95219 | AETNA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $736 | — | $736 | 5.03% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 1390 WILLOW PASS ROAD, SUITE 410 CONCORD, CA 94520 | VISION SERVICE PLAN | $179 | — | $179 | 1.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 50 CALIFORNIA STREET, SUITE 650 SAN FRANCISCO, CA 94111 | HARTFORD LIFE AND ACCIDENT | $113 | — | $113 | 15.07% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 283 | $1.4M |
| Dental | DELTA DENTAL OF OHIO | 292 | $102K |
| Vision | VISION SERVICE PLAN | 101 | $15K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 104 | $23K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $35K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 283 | $1.4M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 104 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.