| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 424 WILLIAM STREET WILLIAMSPORT, PA 17701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 2.53% |
| USI INSURANCE SERVICES LLC3 | DC METRO OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.98% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE FLOOR 1 FLORHAM PARK, NJ 07932 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER ROAD CN1011 SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $892 | — | $892 | 0.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 424 WILLIAM STREET WILLIAMSPORT, PA 17701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.52% |
| USI INSURANCE SERVICES LLC3 | DC METRO OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.12% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE FLOOR 1 FLORHAM PARK, NJ 07932 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER ROAD CN1011 SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $716 | — | $716 | 0.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 424 WILLIAM STREET WILLIAMSPORT, PA 17701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.52% |
| USI INSURANCE SERVICES LLC3 | DC METRO OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.06% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVE FLOOR 1 FLORHAM PARL, NJ 07932 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $931 | — | $931 | 1.68% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 190 RIVER ROAD CN1011 SUMMIT, NJ 07901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $222 | — | $222 | 0.40% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203510 PHILADELPHIA DALLAS, TX 75320 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $222 | — | $222 | 0.40% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS,COUNSELMAN, MICHAELS & DOWNES | 555 FAIRMOUNT AVE BALTIMORE, MD 21286 | ACE AMERICAN INSURANCE COMPANY | $15K | — | $15K | 27.89% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS,COUNSELMAN, MICHAELS & DOWNES | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | ACE AMERICAN INSURANCE COMPANY | $0 | — | $0 | — |
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 | 935 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 963 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HIGHMARK BLUE SHIELD | 717 | $8.9M |
| Vision | HIGHMARK BLUE SHIELD | 717 | $8.8M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 755 | $165K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 680 | $85K |
| Prescription drug | HIGHMARK BLUE SHIELD | 717 | $8.8M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 935 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 935 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.