| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | MEDICAL MUTUAL OF OHIO | $54K | $36K | $90K | 3.67% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $12K | $83 | $12K | 5.91% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 13.35% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | $0 | $4K | 15.61% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN SUITE 250 DUBLIN, OH 43017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $417 | $0 | $417 | 10.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 26 CENTURY BOULEVARD NASHVILLE, TN 37214 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19 | $0 | $19 | 0.49% |
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 | 332 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 232 | $2.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 440 | $208K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 346 | $27K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 440 | $234K |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 440 | $234K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 232 | $2.5M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 440 | $238K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.