| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | — | $773 | $773 | 0.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | AETNA INSURANCE COMPANY | $5K | — | $5K | 1.70% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VI 23466 | AETNA INSURANCE COMPANY | $3K | — | $3K | 0.99% |
| USI INSURANCE SERVICES LLC3 | 312 ELM ST 24TH FLOOR CINCINNATI, OH 45202 | AETNA INSURANCE COMPANY | $3K | — | $3K | 0.78% |
| AMY PARTEE3 | 6665 STONE RD MEDINA, OH 44256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27K | — | $27K | 22.80% |
| VALENE M WOLFE3 | 1265 CIRCLE DRIVE AKRON, OH 44310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $178 | $4K | 3.25% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $308 | $3K | 2.95% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.04% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DRIVE WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $15 | $30 | 0.03% |
| PHILLIP MCHONE3 | 1233 VILLAGE DR YADKINVILLE, NC 27055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $14 | $25 | 0.02% |
| JOSEPH J. WACHEL3 Filed as: JOSEPH J WACHEL | 1648 MARKEY LANE FLOSSMOOR, IL 60422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| DAVID L SMELCER3 | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| UN HUI SMITH3 | PO BOX 1722 DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | PO BOX 644213 PITTSBURGH, PA 15264 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DR LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| RICHARD STURM3 | 3231 SOUTH HALSTED CHICAGO, IL 60608 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 | 31805 TEMEOULA PARKWAY TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| PHIL COLEMAN3 | 18908 RIVERWIND LN DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| GLEN E MILLER3 | 8566 FALLBROOK CIR HUNTINGTON BEACH, CA 92646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | VISION SERVICE PLAN | $2K | — | $2K | 2.59% |
| USI INSURANCE SERVICES LLC3 | 6393 OAK TREE BLVD STE 100 INDEPENDENCE, OH 441316958 | VISION SERVICE PLAN | $524 | — | $524 | 0.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 7.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | ANTHEM LIFE INSURANCE COMPANY | $339 | — | $339 | 1.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Other fees; Contract Administrator Service code 12 | — | $489K |
| USI INS SERVICES LLC SERVICE PROVIDER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | PO BOX 62889 VIRGINIA BEACH, OH 23466 | $66K |
| USI MIDWEST LLC SERVICE PROVIDER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 26650 RENAISSANCE PKWY STE 7 CLEVELAND, OH 44128 | $42K |
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 | 568 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 589 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA INSURANCE COMPANY | 1,036 | $324K |
| Vision | VISION SERVICE PLAN | 448 | $68K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 794 | $139K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 625 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,036 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.