| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.00% |
| USI INSURANCE SERVICES LLC3 | 1301 EAST 9TH STREET SUITE 3800 CLEVELAND, OH 44114 | EYEMED VISION CARE ON BEHALF OF THE COMBINED INSURANCE COMPANY | $15K | — | $15K | 11.60% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES NA | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 13.99% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 14.01% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $2K | $9K | 7.63% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $892 | $3K | 4.83% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.40% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $703 | $4K | 10.97% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $226 | — | $226 | 3.40% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $199 | — | $199 | 3.40% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $509 | $116 | $625 | 10.96% |
| USI INSURANCE SERVICES LLC | P.O. BOX 62889 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $236 | $400 | $636 | 11.60% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES NATIONAL INC | 1301 EAST 9TH STREET SUITE 3800 CLEVELAND, OH 44114 | EYEMED VISION CARE ON BEHALF OF THE COMBINED INSURANCE COMPANY | $31 | — | $31 | 9.42% |
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 | 1,877 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,883 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 2,997 | $828K |
| Vision(2 contracts) | EYEMED VISION CARE ON BEHALF OF THE COMBINED INSURANCE COMPANY | 2,516 | $133K |
| Life insurance(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $136K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $253K |
| Other(6 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $265K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,997 | — |
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.