| 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 | $11K | $5K | $16K | 14.42% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | DELTA DENTAL OF INDIANA | $0 | $144 | $144 | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.01% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.66% |
| BRIAN OBAL3 | 3190 FAIRVIEW PARK DRIVE, SUITE 40 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.02% |
| KELLY HALL WIENING4 | 2835 FIR LANE SOUTH BEND, IN 46615 | PRE-PAID LEGAL SERVICES INC., DBA LEGALSHIELD | $297 | $0 | $297 | 9.88% |
| JJ AND DR ENTERPRISES LLC4 Filed as: J.J. AND D.R. ENTERPRISES, LLC | 72057 COUNTY ROAD 17 NEW PARI, IN 46553 | PRE-PAID LEGAL SERVICES INC., DBA LEGALSHIELD | $283 | $0 | $283 | 9.41% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | HARTFORD LIFE AND ACCIDENT | $113 | $38 | $151 | 20.13% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 223 | $83K |
| Vision | VISION SERVICE PLAN | 114 | $22K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 118 | $108K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 118 | $108K |
| Other(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 203 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.