| 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 | $49K | $30K | $79K | 3.91% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 6949 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 7.49% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 5.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 4.37% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $899 | $0 | $899 | 6.44% |
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 DUBLIN, OH 43017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $188 | $0 | $188 | 5.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 1001 LAKESIDE AVENUE, SUITE 1600 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13 | $0 | $13 | 0.40% |
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 | 293 | 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) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 217 | $2.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 380 | $152K |
| Vision | VISION SERVICE PLAN | 117 | $14K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 380 | $207K |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 380 | $207K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 217 | $2.0M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 380 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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.