| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $25K | $64K | $88K | 1.20% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $6K | $8K | 0.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $13K | $26K | 18.49% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.85% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $12K | $17K | 16.84% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21 | $0 | $21 | 0.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $8K | $16K | 18.60% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $745 | $0 | $745 | 0.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 20.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $399 | $0 | $399 | 1.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $49 | $49 | 0.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 29.96% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $394 | $0 | $394 | 2.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC. | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 9.30% |
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 | 1,062 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,069 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 634 | $7.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 634 | $7.4M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 634 | $7.4M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 943 | $174K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 732 | $103K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $99K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 634 | $7.4M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 943 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 943 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.