| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 ATRIUM 2 SOUTH TOWER DUBLIN, OH 43017 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | $0 | $19K | 3.23% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $200 | $200 | 0.03% |
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 ATRIUM 2 SOUTH TOWER DUBLIN, OH 43017 | VISION BENEFITS OF AMERICA | $8K | $0 | $8K | 10.00% |
| KEY BENEFIT ADMINISTRATORS, INC3 Filed as: KEY BENEFIT ADMINISTRATORS, INC. | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | COMPANION LIFE INSURANCE | $0 | $26K | $26K | 57.54% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE | $5K | $9K | $14K | 30.45% |
| AMERICAN HEALTH DATA INSTITUTE3 | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | COMPANION LIFE INSURANCE | $0 | $7K | $7K | 15.70% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: CHARLES DAVE BROWN | 1335 CENTRAL AVENUE ASHLAND, KY 41101 | COMPANION LIFE INSURANCE | $2K | $4K | $7K | 14.48% |
| PHCS3 Filed as: MULTIPLAN | 115 5TH AVENUE, 7TH FLOOR NEW YORK, NY 10003 | COMPANION LIFE INSURANCE | $0 | $2K | $2K | 5.29% |
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 ATRIUM 2 SOUTH TOWER DUBLIN, OH 43017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $266 | $3K | 13.08% |
| USI INSURANCE SERVICES LLC3 | 5455 RINGS ROAD, SUITE 250 ATRIUM 2 SOUTH TOWER DUBLIN, OH 43017 | VISION BENEFITS OF AMERICA | $2K | $0 | $2K | 10.00% |
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 | 206 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 61 | $621K |
| Dental | VISION BENEFITS OF AMERICA | 129 | $81K |
| Vision | VISION BENEFITS OF AMERICA | 165 | $17K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $22K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $22K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $22K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 61 | $576K |
| Other(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE | 206 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.