| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $45K | — | $45K | 2.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC | MID ATLANTIC PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $6K | $11K | 13.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62817 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF PENNSYLVANIA | $3K | — | $3K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SCVS LLC | MID ATLANTIC PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 17.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC | MID ATLANTIC PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 21.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HIGHMARK, INC | $485 | — | $485 | 3.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC | MID ATLANTIC PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 18.51% |
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 | 145 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 215 | $1.6M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 216 | $61K |
| Vision | HIGHMARK, INC | 219 | $16K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 135 | $82K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $18K |
| Prescription drug | UPMC HEALTH OPTIONS | 215 | $1.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.