| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NY 07932 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 9.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.58% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $4K | $7K | 8.24% |
| EBENEFIT MARKETPLACE, LLC3 Filed as: EBENEFIT MARKETPLACE LLC | 37 BROADWAY, 2ND FLOOR NORTH HAVEN, CT 06473 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.00% |
| EMPLOYEE NAVIGATOR, LLC3 Filed as: EMPLOYEE NAVIGATOR LLC | 7979 OLD GEORGETOWN ROAD, SUITE 300 BETHESDA, MD 20814 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $216 | $216 | 0.25% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 26.67% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | UNKNOWN CHARLOTTESVILLE, VA 22902 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $994 | $994 | 3.84% |
| FAY JETER MARTIN3 | 19220 FOREST ROAD LYNCHBURG, VA 24502 | AFLAC | $821 | $0 | $821 | 6.52% |
| MJ INSURANCE3 Filed as: DAVID W. HARLESS AND VARIOUS AGENTS | 3412 MANOR GROVE CIRCLE GLEN ALLEN, VA 23059 | AFLAC | $214 | $0 | $214 | 1.70% |
| JACQUELINE FAY MARTIN3 | 428 DEEP RUN ROAD CARTERSVILLE, VA 23027 | AFLAC | $175 | $0 | $175 | 1.39% |
| TEMPLE SCOTT JENKINS3 | 6550 GREEN BAY ROAD GREEN BAY, VA 23942 | AFLAC | $131 | $0 | $131 | 1.04% |
| LEWIS K GATHRIGHT JR3 Filed as: LEWIS K. GATHRIGHT JR. | PO BOX 165 GOOCHLAND, VA 23063 | AFLAC | $83 | $0 | $83 | 0.66% |
| WANDA LEE MADDOX3 | PO BOX 346 CROZET, VA 22932 | AFLAC | $66 | $0 | $66 | 0.52% |
| JEFFREY WHITE3 | 8250 PORTERS CROSSING WAY WILMINTON, NC 28411 | AFLAC | $63 | $0 | $63 | 0.50% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | OPTIMA HEALTH PLAN | 131 | $1.2M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 151 | $86K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 255 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $98K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $98K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $98K |
| Prescription drug(2 contracts) | OPTIMA HEALTH PLAN | 131 | $1.2M |
| Other(5 contracts, 4 carriers) | OPTIMA HEALTH PLAN | 154 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.