| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | $31K | $2K | $32K | 3.88% |
| SHAWAN MARQUIS AGENCY INC3 Filed as: SHAWAN MARQUIS AGENCY, INC. | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | COMMUNITY INSURANCE COMPANY | $319 | $0 | $319 | 0.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY INSURANCE | 3931 SOUTH DIXIE DRIVE DAYTON, OH 43126 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $3K | $3K | 6.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $1K | $447 | $2K | 19.97% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER AGENCY INSURANCE | 3931 SOUTH DIXIE DRIVE DAYTON, OH 43126 | HARTFORD LIFE AND ACCIDENT | -$3 | -$2 | -$5 | -0.05% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 162 | $833K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 177 | $36K |
| Vision | COMMUNITY INSURANCE COMPANY | 162 | $833K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 119 | $9K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 162 | $833K |
| Other | HARTFORD LIFE AND ACCIDENT | 119 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.