| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $9K | $17K | 13.20% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DR E CHARLESTON, WV 25311 | DELTA DENTAL OF OHIO | $4K | $309 | $4K | 5.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $180 | — | $180 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Other services; Claims processing Service code 12 | — | $250K |
| USI INS SERVICES LLC | Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 201 ALHAMBRA CIR STE 801 CORAL GABLES, FL 33134 | $55K |
| INGENIORX INC EIN 82-3062245 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Other services; Claims processing Service code 12 | — | -$54K |
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 | 179 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 258 | $82K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 194 | $128K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 194 | $128K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 214 | $378K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.