| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | COMMUNITY INSURANCE COMPANY | — | $2K | $2K | 0.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | $11K | $22K | 7.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $20K | $10K | $31K | 22.66% |
| AMY PARTEE3 | 6665 STONE RD MEDINA, OH 44256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17K | — | $17K | 13.71% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $17 | $2K | 1.67% |
| VALENE M WOLFE3 | 1265 CIRCLE DRIVE AKRON, OH 44310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $33 | $2K | 1.33% |
| MAGNONE FINANCIAL SERVICES CORP3 | 3151 OUTRIGGER AVE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.04% |
| JOSEPH J. WACHEL3 Filed as: JOSEPH J WACHEL | 1648 MARKEY LANE FLOSSMOOR, IL 60422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.02% |
| DAVID L SMELCER3 | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 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% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DRIVE WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 0.01% |
| PHILLIP MCHONE3 | 1233 VILLAGE DR YADKINVILLE, NC 27055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.00% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 11412 ROBBIA DR LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| UN HUI SMITH3 | PO BOX 1722 DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| RICHARD STURM3 | 3231 SOUTH HALSTED CHICAGO, IL 60608 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| GROUP SUPPLEMENTAL BENEFITS INC3 | 31805 TEMECULA PARKWAY TEMECULA, CA 92592 | 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% |
| PHIL COLEMAN3 | 18908 RIVERWIND LN DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 6393 OAK TREE BLVD STE 100 INDEPENDENCE, OH 441316958 | VISION SERVICE PLAN | $2K | — | $2K | 2.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $4K | $14K | 21.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 234662889 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 7.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 SERVICE PROVIDER | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Float revenue Service code 12 | — | $532K |
| USI INS SERVICES LLC SERVICE PROVIDER | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | $106K |
| USI MIDWEST LLC | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $2K |
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 | 635 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 643 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 540 | $307K |
| Vision | VISION SERVICE PLAN | 500 | $77K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 885 | $174K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 884 | $135K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 1,224 | $661K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 885 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,224 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.