| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $11K | 9.53% |
| CGI VOLUNTARY BENEFITS, INC.3 | 20046 WALKER ROAD, SUITE 5 SHAKER HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 38.66% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $738 | $0 | $738 | 7.36% |
| EJBOLAND3 | 28030 WEST OAKLAND ROAD BAY VILLAGE, OH 44140 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $17 | $0 | $17 | 0.17% |
| JILL H. JAMES3 | 20108 LAVERNE AVENUE ROCKY RIVER, OH 44116 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6 | $0 | $6 | 0.06% |
| UNKNOWN3 | UNKNOWN CLEVELAND, OH 44113 | TELADOC | $761 | $0 | $761 | 15.00% |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $115K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $115K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $125K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $115K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $115K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.