| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $13K | $48 | $13K | 0.56% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 2.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 2.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $323 | $323 | 0.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $13K | $7K | $21K | 17.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 4.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 1.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $126 | $126 | 0.18% |
| CGI VOLUNTARY BENEFITS, INC.3 | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | $0 | $5K | 25.78% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.86% |
| JILL H. JAMES3 | 20108 LAVERNE AVENUE ROCKY RIVER, OH 44116 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.74% |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 55 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 436 | $3.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 436 | $2.4M |
| Vision | AETNA LIFE INSURANCE COMPANY | 436 | $2.4M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 353 | $119K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 353 | $119K |
| Prescription drug(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 436 | $3.0M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 353 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.