| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1753 PINNACLE DRIVE SUITE 800 MCLEAN, VA 22102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23K | $3K | $25K | 7.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1753 PINNACLE DRIVE, SUITE 800 MCLEAN, VA 22102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 0.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 ACCOUNTING DEPARTMENT CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $49 | $0 | $49 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $42 | $42 | 0.01% |
| CHRISTOPHER JOHN NICELEY3 | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21 | $0 | $21 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN WASHINGTON, DC 20037 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $0 | $5K | 10.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN WASHINGTON, DC 20037 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN WASHINGTON, DC 20037 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN WASHINGTON, DC 20037 | LIFE INSURACE COMPANY OF NORTH AMERICA | $122 | $0 | $122 | 11.02% |
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 | 457 | 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) | 457 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 9 | $149K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 9 | $120K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 600 | $43K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 536 | $362K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 536 | $360K |
| Other(6 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 536 | $546K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 600 | — |
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.