| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | P.O. BOX 62949 ATTN WEST VIRGINIA BEACH, VA 23466 | ANTHEM HEALTH PLANS, INC. | $29K | $260 | $29K | 12.71% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | ANTHEM HEALTH PLANS, INC. | $10K | — | $10K | 4.49% |
| USI INSURANCE SERVICES LLC3 | NEW ENGLAND P.O. BOX 62937 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 9.73% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1 CALIFORNIA STREET SUITE 400 SAN FRANCISCO, CA 94111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 HUDSON STREET NEW YORK, NY 100144504 | VISION SERVICE PLAN | $348 | — | $348 | 1.75% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62937 VIRGINIA BEACH, VA 234662937 | VISION SERVICE PLAN | $252 | — | $252 | 1.27% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVE FLOOR 3 MERIDEN, CT 064504893 | VISION SERVICE PLAN | $224 | — | $224 | 1.13% |
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 | 168 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS, INC. | 210 | $231K |
| Dental | ANTHEM HEALTH PLANS, INC. | 210 | $231K |
| Vision | VISION SERVICE PLAN | 211 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $80K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $80K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $80K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS, INC. | 210 | $231K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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.