| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE EMPLOYEE BENEFIT SERVICE CENTER3 | 4430 KANAWHA TURNPIKE SOUTH CHARLESTON, WV 25309 | UNITED STATES FIRE INSURANCE COMPANY | $0 | $73K | $73K | 23.39% |
| INTRA STATE INSURANCE CORP3 Filed as: INTRA-STATE INSURANCE | PO BOX 5526 VIENNA, WV 26105 | UNITED STATES FIRE INSURANCE COMPANY | $37K | — | $37K | 11.76% |
| S&S HEALTHCARE3 Filed as: S & S HEALTHCARE | 1385 KEMPER MEADOW DRIVE CINCINNATI, OH 45240 | UNITED STATES FIRE INSURANCE COMPANY | $0 | $27K | $27K | 8.74% |
| QUALITY CARE PARTNERS3 | 2806 BELL STREET ZANESVILLE, OH 43701 | UNITED STATES FIRE INSURANCE COMPANY | $0 | $4K | $4K | 1.17% |
| INTRA STATE INSURANCE CORP3 Filed as: INTRA STATE INSURANCE CORPORATON | P.O. BOX 5526 VIENNA, WV 261055526 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 15.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 408 9TH STREET HUNTINGTON, WV 25701 | DELTA DENTAL OF PENNSYLVANIA | $4K | — | $4K | 10.00% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 3727 NORFOLK, VA 235143727 | VISION SERVICE PLAN | $699 | — | $699 | 3.97% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62837 VIRGINIA BEACH, VA 234662827 | VISION SERVICE PLAN | $322 | — | $322 | 1.83% |
| DAVID B. WILSON3 | P.O. BOX 378 BELMONT, WV 26134 | ALLSTATE BENEFITS | $449 | — | $449 | 6.24% |
| ERIC FITZER3 | P.O. BOX 5526 VIENNA, WV 26105 | ALLSTATE BENEFITS | $332 | — | $332 | 4.62% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED STATES FIRE INSURANCE COMPANY | 132 | $319K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 162 | $36K |
| Vision | VISION SERVICE PLAN | 88 | $18K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 327 | $64K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 327 | $56K |
| Prescription drug | UNITED STATES FIRE INSURANCE COMPANY | 132 | $312K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 327 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.