| 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 | $23K | $14K | $38K | 3.91% |
| USI INSURANCE SERVICES LLC3 | 100 SIMMIT LAKE DRIVE VALHALLA, NY 10595 | SIDECAR HEALTH INSURANCE COMPANY | $8K | $0 | $8K | 4.94% |
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 DUBLIN, OH 43017 | AMERICAN UNITED LIFE INSURANCE COMPANY | $11K | $0 | $11K | 12.01% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | DELTA DENTAL OF OHIO | $3K | $0 | $3K | 3.75% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | DELTA DENTAL OF OHIO | $822 | $0 | $822 | 1.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | $505 | $72 | $577 | 5.70% |
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 | 155 | 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) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 182 | $1.1M |
| Dental | DELTA DENTAL OF OHIO | 184 | $67K |
| Vision | COMMUNITY INSURANCE COMPANY | 175 | $10K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 154 | $95K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 154 | $95K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 154 | $95K |
| Prescription drug(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 182 | $1.1M |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 154 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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."
No prospect flags tripped on this filing.