| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICE LLC | 100 SUMMIT LAKE DRIVE STE 400 VALHALLA, NY 10595 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $10K | — | $10K | 1.78% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE VALHALLA, NY 10595 | DELTA DENTAL OF IOWA | $3K | $422 | $4K | 4.57% |
| IA SCHOOLS EMPL BENEFITS ASSOC3 | 4949 WESTOWN PARKWAY WEST DES MOINES, IA 50266 | DELTA DENTAL OF IOWA | $364 | $68 | $432 | 0.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 17.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI ISNURANCE SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.31% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 16.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.37% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $978 | $978 | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 19.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 62889 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $659 | — | $659 | 5.24% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $629 | $629 | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 17.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $788 | — | $788 | 6.33% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $623 | $623 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| USI INSURANCE SERVICES LLC AGENT/BROKER | Insurance agents and brokers Service code 22 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | $15K |
| USI INSURANCE SERVICE LLC AGENT/BROKER | Insurance agents and brokers Service code 22 | 100 SUMMIT LAKE DR STE400 VALHALLA, NY 10595 | $10K |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 115 | $1.3M |
| Dental | DELTA DENTAL OF IOWA | 141 | $81K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $20K |
| Prescription drug(3 contracts, 2 carriers) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 115 | $1.3M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.