| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | MEDICAL MUTUAL OF OHIO | $44K | $5K | $49K | 1.94% |
| USI INSURANCE SERVICES LLC3 | 2375 EAST CAMELBACK ROAD SUITE 250 PHOENIX, AZ 85016 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $7K | $11K | 7.81% |
| USI INSURANCE SERVICES LLC3 | CINCINNATI OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $7K | $16K | 25.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | CLEVELAND OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.22% |
| USI INSURANCE SERVICES LLC3 | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.65% |
| GREEN HAZEL ASSOCIATES INC3 Filed as: GREEN SHADES SOFTWARE INC | 7020 A C SKINNER PARKWAY SUITE 100 JACKSONVILLE, FL 32256 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 1.76% |
| USI INSURANCE SERVICES LLC3 | CINCINNATI OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $5K | $7K | 11.42% |
| USI INSURANCE SERVICES LLC3 | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.44% |
| USI INSURANCE SERVICES LLC3 | CLEVELAND OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $804 | — | $804 | 1.38% |
| USI INSURANCE SERVICES LLC3 | CINCINNATI OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 26.22% |
| USI INSURANCE SERVICES LLC3 | CLEVELAND OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.32% |
| USI INSURANCE SERVICES LLC3 | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.17% |
| GREEN HAZEL ASSOCIATES INC3 Filed as: GREEN SHADES SOFTWARE INC | 7020 A C SKINNER PARKWAY SUITE 100 JACKSONVILLE, FL 32256 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.08% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET 24TH FLOOR CINCINNATI, OH 45202 | MEDICAL MUTUAL | — | $462 | $462 | 1.51% |
| USI INSURANCE SERVICES LLC3 | CINCINNATI OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $521 | $3K | $3K | 45.94% |
| GREEN HAZEL ASSOCIATES INC3 Filed as: GREEN SHADES SOFTWARE INC | 7020 A C SKINNER PARKWAY SUITE 100 JACKSONVILLE, FL 32256 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 15.45% |
| USI INSURANCE SERVICES LLC3 | CLEVELAND OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $198 | — | $198 | 2.76% |
| USI INSURANCE SERVICES LLC3 | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $176 | $176 | 2.45% |
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 | 549 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 557 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 343 | $140K |
| Vision | MEDICAL MUTUAL | 269 | $31K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 901 | $60K |
| Short-term disability | CONSUMERS LIFE INSURANCE COMPANY | 203 | $62K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 244 | $63K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 346 | $2.5M |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 901 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.