| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $5K | $15K | 7.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $7K | $12K | 12.58% |
| BE SOLUTIONS LLC3 | 276 S LOGAN ST ELYRIA, OH 44035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $183 | — | $183 | 0.19% |
| GREEN LINE BENEFITS3 | 5150 TAMIAMI TRAIL NORTH STE 501 NAPLES, FL 34103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 6.06% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD 2ND FL HAUPPAUGE, NY 11788 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | — | $2K | 3.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $11K | 21.60% |
| BE SOLUTIONS LLC3 | 276 S LOGAN ST ELYRIA, OH 44035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $557 | — | $557 | 1.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JP FARLEY CORPORATION EIN 34-1363719 NONE | Claims processing Service code 12 | 29055 CLEMENS ROAD WESTLAKE, OH 44145 | $166K |
| KOEHLER FITZGERALD LLC EIN 27-4209347 NONE | Legal Service code 29 | 1111 SUPERIOR AVE EAST SUITE 2500 CLEVELAND, OH 44114 | $36K |
| MEDWATCH LLC EIN 16-1662117 NONE | Claims processing Service code 12 | PO BOX 21796 TAMPA, FL 33630 | $9K |
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 | 252 | 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) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 359 | $200K |
| Vision | VISION SERVICE PLAN | 308 | $57K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 512 | $144K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 292 | $81K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 512 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 512 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.