| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2975 REGENT BOULEVARD IRVING, TX 75063 | PRINCIPAL LIFE INSURANCE COMPANY | $83K | $0 | $83K | 10.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGNIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | $0 | $17K | 2.07% |
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 0.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203491 DALLAS, TX 75320 | DELTA DENTAL OF VIRGINIA | $48K | $0 | $48K | 7.98% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $28K | $0 | $28K | 13.77% |
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH, SUITE 400 COLOMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 6.24% |
| MJ INSURANCE3 Filed as: TERRY J. SILVERS AND VARIOUS AGENTS | 100 GREENLEAF DRIVE FLAT ROCK, NC 28731 | AFLAC | $7K | $0 | $7K | 6.41% |
| DAVID E SHELL JR3 Filed as: DAVID E. SHELL JR. | 102 MACTANLY PLACE, SUITE C STAUNTON, VA 24401 | AFLAC | $2K | $0 | $2K | 1.53% |
| ELIZABETH A COOK MILLER3 Filed as: ELIZABETH A. COOK MILLER | 86 OLD LAUREL HILL ROAD VERONA, VA 24482 | AFLAC | $1K | $0 | $1K | 1.30% |
| RICHARD L TUSING3 Filed as: RICHARD L. TUSING | 30 YORK COURT STAUNTON, VA 24401 | AFLAC | $973 | $0 | $973 | 0.88% |
| VICKIE LOSNES3 Filed as: VICKIE Y. LOSNES | 8540 GOODVIEW ROAD GOODVIEW, VA 24095 | AFLAC | $630 | $0 | $630 | 0.57% |
| BONNIE L TAFT3 Filed as: BONNIE L. TAFT | 573 CANE RUN STREET HARRODSBURG, KY 40330 | AFLAC | $616 | $0 | $616 | 0.56% |
| LARRY W SHOWALTER3 Filed as: LARRY W. SHOWALTER | 2515 EAST MARKET STREET, SUITE E HARRISONBURG, VA 22801 | AFLAC | $451 | $0 | $451 | 0.41% |
| DAVID E SHELL JR3 Filed as: DAVID E. SHELL JR. AND OTHER AGENTS | 192 GREENVILLE FARM LANE STAUNTON, VA 24401 | AFLAC | $143 | $0 | $143 | 3.50% |
| SCOTT W GAGE3 Filed as: SCOTT W. GAGE | PO BOX 1 BOUCKVILLE, NY 13310 | AFLAC | $66 | $0 | $66 | 1.61% |
| MARY FRANCES CARLTON3 | 3824 HOGAN ROAD VERNON CENTER, NY 13477 | AFLAC | $51 | $0 | $51 | 1.25% |
| EDWARD D YATES JR3 Filed as: EDWARD D. YATES JR. | 2063 COUNTY ROUTE 8 OSWEGO, NY 13126 | AFLAC | $47 | $0 | $47 | 1.15% |
| MELVIN R JONES3 Filed as: MELVIN R. JONES | 3025 ELIOCH MANOR DRIVE POWHATAN, VA 23139 | AFLAC | $44 | $0 | $44 | 1.08% |
| DAWN PELLERIN3 Filed as: DAWN M. PELLERIN | 34 TAMARACK DRIVE NEW HARTFORD, NY 13413 | AFLAC | $30 | $0 | $30 | 0.73% |
| STEVEN E DALABA3 Filed as: STEVEN E. DALABA | 7683 SEDGEWICK RIDGE ROAD LEWISVILLE, NC 27023 | AFLAC | $30 | $0 | $30 | 0.73% |
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 | 1,532 | 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) | 1,532 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | AFLAC | 159 | $115K |
| Dental | DELTA DENTAL OF VIRGINIA | 2,077 | $605K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,279 | $87K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,567 | $798K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,567 | $798K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,567 | $798K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 620 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,077 | — |
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.