| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | P.O. BOX 62889 - ATTN MIDWEST VIRGINIA BEACH, VA 234662889 | COMMUNITY INSURANCE COMPANY | — | $321 | $321 | 0.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | P O BOX 3716 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 3.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | P O BOX 62889 VIRGINIA BEACH, VA 234662889 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 3.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | P O BOX 62889 VIRGINIA BEACH, VA 234662889 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $859 | — | $859 | 1.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC | P O BOX 62889 VIRGINIA BEACH, VA 234662889 | VISION SERVICE PLAN | $1K | — | $1K | 2.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, LLC. | P O BOX 62889 VIRGINIA BEACH, VA 234662889 | VISION SERVICE PLAN | $431 | — | $431 | 0.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | P O BOX 3716 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 7.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST, INC. | P O BOX 3716 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 7.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | P O BOX 3716 NORFOLK, VA 235143716 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 6.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 | Float revenue; Claims processing; Other services; Contract Administrator; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $148K |
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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 208 | $78K |
| Vision | VISION SERVICE PLAN | 189 | $47K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 317 | $69K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 299 | $39K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 175 | $299K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 317 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.