| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 312 ELM ST 24TH FL CINCINNATI, OH 45202 | COMMUNITY INSURANCE COMPANY | $23K | — | $23K | 4.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM ST 24TH FLOOR CINCINNATI, OH 452022701 | HUMANA HEALTH PLAN OF OHIO, INC. | $8K | $2K | $10K | 3.63% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 222 S RIVERSIDE PLAZA SUITE 630 CHICAGO, IL 60606 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $457 | $3K | 7.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | COMMUNITY INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST | P.O. BOX 62889 VIRGINIA BEACH, VA 24366 | SUPERIOR DENTAL CARE, INC. | $1K | — | $1K | 6.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | CINCINNATI, OH PO BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $952 | — | $952 | 10.78% |
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 | 165 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 100 | $743K |
| Dental(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 165 | $51K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 165 | $9K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 135 | $48K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 135 | $48K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 135 | $48K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 135 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.