| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DR E CHARLESTON, WV 25311 | DELTA DENTAL PLAN OF OHIO | $37K | — | $37K | 7.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-LI | $17K | — | $17K | 7.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-LI | $13K | — | $13K | 5.62% |
| ADP INC3 Filed as: ADP LLC KATIE BENSON-BRAY | 9016 SILVER LAKE DR CEDAR HILLS, UT 840628788 | RELIASTAR LIFE INSURANCE COMPANY-LI | — | $1K | $1K | 0.54% |
| 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 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | $9K | — | $9K | 5.64% |
| ADP INC3 Filed as: ADP LLC KATIE BENSON-BRAY | 9016 SILVER LAKE DR CEDAR HILLS, UT 840628788 | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | — | $1K | $1K | 0.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-STD | $10K | — | $10K | 7.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | RELIASTAR LIFE INSURANCE COMPANY-STD | $8K | — | $8K | 5.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | — | $265K |
| USI INSURANCE SERVICES LLC EIN 31-1440175 | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 201 ALHAMBRA CIRCLE STE 801 CORAL GABLES, FL 33134 | $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 | 773 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 773 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 1,207 | $962K |
| Dental | DELTA DENTAL PLAN OF OHIO | 1,206 | $462K |
| Vision | COMMUNITY INSURANCE COMPANY - VISION | 1,054 | $71K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY-LI | 893 | $238K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY-STD | 508 | $144K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | 893 | $155K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 1,207 | $962K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 1,207 | $962K |
| Other | RELIASTAR LIFE INSURANCE COMPANY-ADD/LTD | 893 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,207 | — |
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.