| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | — | COMMUNITY INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 CINCINNATI OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC- MIDWEST | PO BOX 62889 GRAND RAPIDS OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | $1K | — | $1K | 6.27% |
| USI INSURANCE SERVICES LLC3 | 200 WEST CYPRESS CREEK ROAD #500 FORT LAUDERDALE, FL 33309 | COMMUNITY INSURANCE COMPANY | $542 | — | $542 | 2.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 CINCINNATI OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC- MIDWEST | PO BOX 62889 GRAND RAPIDS OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $923 | $923 | 4.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 CINCINNATI OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $954 | — | $954 | 15.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC- MIDWEST | PO BOX 62889 GRAND RAPIDS OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $258 | $258 | 4.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- MIDWEST | PO BOX 62889 CINCINNATI OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $514 | — | $514 | 10.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC- MIDWEST | PO BOX 62889 GRAND RAPIDS OPCO VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $288 | $288 | 5.61% |
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 | 238 | 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) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMMUNITY INSURANCE COMPANY | 151 | $92K |
| Vision | COMMUNITY INSURANCE COMPANY | 142 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 392 | $43K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $25K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 183 | $297K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 392 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 392 | — |
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.