| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1301 E. 9TH ST. SUITE 3800 CLEVELAND, OH 44114 | COMMUNITY INSURANCE COMPANY | $69K | — | $69K | 0.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 213 SOUTH JEFFERSON STREET SW ROANOKE, VA 24011 | COMMUNITY INSURANCE COMPANY | $17K | — | $17K | 0.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | COMMUNITY INSURANCE COMPANY | $255 | — | $255 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 201572 DALLAS, TX 75320 | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG., INC. | $34K | — | $34K | 1.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | TUFTS ASSOCIATED HEALTH MAINTANANCE ORG., INC. | $11K | — | $11K | 0.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1301 E. 9TH ST. CLEVELAND, OH 44114 | COMMUNITY INSURANCE COMPANY | $5K | — | $5K | 0.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | COMMUNITY INSURANCE COMPANY | $2K | — | $2K | 0.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1301 EAST 9TH STREET SUITE 3800 CLEVELAND, OH 44114 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 0.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 0.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 0.47% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1301 EAST 9TH STREET SUITE 3800 CLEVELAND, OH 44114 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $7K | — | $7K | 9.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93245 NETWORK PLACE CHICAGO, IL 60673 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 4.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 2975 REGENT BLVD IRVING, TX 75063 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $620 | — | $620 | 0.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 1001 LAKESIDE AVE E CLEVELAND, OH 44114 | ZURICH AMERICAN INSURANCE COMPANY | $167 | — | $167 | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 1301 E. 9TH ST. CLEVELAND, OH 44114 | ZURICH AMERICAN INSURANCE COMPANY | $166 | — | $166 | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93245 NETWORK PLACE CHICAGO, IL 60673 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $20 | — | $20 | 5.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1301 EAST 9TH STREET SUITE 3800 CLEVELAND, OH 44114 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $19 | — | $19 | 5.69% |
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 | 1,039 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 38 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,088 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 638 | $12.0M |
| Dental | COMMUNITY INSURANCE COMPANY | 788 | $550K |
| Vision(3 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 1,243 | $9.2M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,066 | $443K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,066 | $443K |
| Prescription drug(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 638 | $12.0M |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 1,039 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,243 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.