| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 100 SUMMIT DRIVE, SUITE 400 VALHALLA, NY 10595 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $376 | $4K | 0.20% |
| USI INSURANCE SERVICES LLC3 | 1301 E. 9TH ST., STE 3800 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 7.85% |
| DAVID CAMPANA INSURANCE LTD3 Filed as: DAVID CAMPANA INS LTD | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 10.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 8.40% |
| OBAL BRIAN3 | 3190 FAIRVIEW PARK DRIVE STE 40 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $201 | $201 | 0.81% |
| COVEY RUN INSURANCE LLC3 | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $148 | — | $148 | 0.60% |
| TAYLOR JAMALICA3 | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $82 | — | $82 | 0.33% |
| BOSTON THOMAS W3 | 1275 W MAPLE ST HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $81 | — | $81 | 0.33% |
| HUFHAND MARK L3 | 925 S MAIN ST NORTH CANTON, OH 44720 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $30 | — | $30 | 0.12% |
| LAYNE FINANCIAL INC3 | 3009 WILMINGTON RD SUITE 100 NEW CASTLE, PA 16105 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23 | — | $23 | 0.09% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 174 | $2.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 174 | $2.1M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 174 | $2.1M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 266 | $138K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 266 | $138K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 266 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.