| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL PLAN OF OHIO | $37K | — | $37K | 7.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-LI | $17K | — | $17K | 7.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203383 DALLAS, TX 753203383 | RELIASTAR LIFE INSURANCE COMPANY-LI | $15K | — | $15K | 6.21% |
| ADP INC Filed as: ADP, LLC | 9016 SILVER LAKE DR CEDAR HILLS, UT 840628788 | RELIASTAR LIFE INSURANCE COMPANY-LI | — | $1K | $1K | 0.47% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-STD | $12K | — | $12K | 7.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203383 DALLAS, TX 753203383 | RELIASTAR LIFE INSURANCE COMPANY-STD | $11K | — | $11K | 6.32% |
| ADP INC3 Filed as: ADP LLC | 9016 SILVER LAKE DR CEDAR HILLS, UT 840628788 | RELIASTAR LIFE INSURANCE COMPANY-STD | $1K | — | $1K | 0.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | $11K | — | $11K | 7.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203383 DALLAS, TX 753203383 | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | $10K | — | $10K | 6.23% |
| ADP INC3 Filed as: ADP LLC | 9016 SILVER LAKE DR CEDAR HILLS, UT 840628788 | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | — | $1K | $1K | 0.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 | Other services; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $384K |
| USI INSURANCE SERVICES NATIONAL INC | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 3475 PIEDMONT RD SUITE 800 ATLANTA, GA 30305 | $0 |
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 | 693 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 693 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 1,185 | $895K |
| Dental | DELTA DENTAL PLAN OF OHIO | 1,154 | $486K |
| Vision | COMMUNITY INSURANCE COMPANY - VISION | 957 | $80K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY-LI | 1,271 | $248K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY-STD | 524 | $168K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | 832 | $157K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 1,185 | $895K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 1,185 | $895K |
| Other | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | 832 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,271 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.