| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SRVCS LLC NEW ENGLAND | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SRVCS LLC NEW ENGLAND | PO BOX 629327 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SRVCS LLC NEW ENGLAND | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SRVCS LLC NEW ENGLAND | PO BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 18.81% |
| KACHELRIES, ROBERT G3 | 4610 HAMILTON BLVD ALLENTWON, PA 18103 | HIGHMARK INC. | $554 | $0 | $554 | 4.39% |
| THE BENECON GROUP3 Filed as: THE BENECON GROUP INC. | PO BOX 5406 LANCASTER, PA 17606 | HIGHMARK INC. | $277 | $0 | $277 | 2.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL ADVANTAGE ASSURANCE COMPANY EIN 45-5492167 ADMIN | Claims processing Service code 12 | — | $66K |
| USI INSURANCE SERVICES (RI) EIN 13-3771734 BROKER | Insurance agents and brokers Service code 22 | — | $47K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Claims processing Service code 12 | — | $30K |
| HEALTHIEST YOU EIN 30-0947669 ADMIN | Claims processing Service code 12 | — | $18K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $10K |
| INNOVU BROKER | Insurance agents and brokers Service code 22 | 2403 SIDNEY ST SUITE 225 PITTSBURGH, PA 15203 | $8K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 ADMIN | Claims processing Service code 12 | — | $6K |
| BSI CORPORATE BENEFITS BROKER | Insurance agents and brokers Service code 22 | 79 W MARKET ST STE 300 BETHLEHEM, PA 18018 | $3K |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HIGHMARK INC. | 274 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $50K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $56K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $46K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 154 | $624K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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.