| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | 312 ELM STREET, STE. 2400 CINCINNATI, OH 45202 | DENTAL CARE PLUS, INC. | $6K | — | $6K | 6.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET, 24TH FL CINCINNATI, OH 452022992 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 8.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $149 | — | $149 | 0.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET, 24TH FL CINCINNATI, OH 452022992 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.22% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $73 | — | $73 | 0.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 312 ELM STREET, 24TH FL CINCINNATI, OH 452022992 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $5K | — | $5K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET, 24TH FL CINCINNATI, OH 452022992 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $63 | — | $63 | 0.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | — | EYEMED | $1K | — | $1K | 9.12% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE | 312 ELM STREET, STE 2400 CINCINNATI, OH 45202 | DENTAL CARE PLUS, INC. | $668 | — | $668 | 7.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Float revenue; Claims processing; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $149K |
| USI MIDWEST LLC NONE | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other commissions Service code 22 | 312 ELM ST, 24TH FLOOR CINCINNATI, OH 45202 | $43K |
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 | 136 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DENTAL CARE PLUS, INC. | 120 | $96K |
| Vision | EYEMED | 267 | $13K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 145 | $66K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 145 | $77K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 145 | $85K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 135 | $282K |
| Other(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 145 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.