| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62819, STE. 700 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $29K | $31K | 5.47% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $15K | $16K | 2.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $887 | $2K | 12.06% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.93% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.87% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $946 | $1K | $2K | 17.61% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 9.81% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $963 | $0 | $963 | 7.57% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $928 | $820 | $2K | 14.22% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 10.15% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $916 | $0 | $916 | 7.45% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 225 KENNETH DR ROCHESTER, NY 14623 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 13.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $499 | $439 | $938 | 12.54% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $623 | $0 | $623 | 8.33% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $511 | $348 | $859 | 16.94% |
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $503 | — | $503 | 9.92% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $148 | $148 | 2.92% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $472 | $293 | $765 | 16.37% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $463 | $0 | $463 | 9.91% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $133 | $133 | 2.85% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $322 | $250 | $572 | 16.54% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $369 | $0 | $369 | 10.67% |
| PAYCHEX INSURANCE AGENCY, INC.5 | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $92 | $92 | 2.66% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 117 | $564K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 117 | $564K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 117 | $564K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $25K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 37 | $13K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 20 | $12K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.