| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 600 HIGHWAY 169 SOUTH FLOOR 18 SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $57 | $10K | 5.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 6100 FAIRVIEW ROAD SUITE 1400 MAC D1067-140 CHARLOTTE, NC 28210 | METROPOLITAN LIFE INSURANCE COMPANY | $416 | $0 | $416 | 0.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203491 DALLAS, TX 75320 | DELTA DENTAL OF VIRGINIA | $3K | $0 | $3K | 2.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 213 SOUTH JEFFERSON STREET SUITE 1402 ROANOKE, VA 24011 | DELTA DENTAL OF VIRGINIA | $1K | $0 | $1K | 0.70% |
| BENEFICIAL ASSOCIATES, INC.3 | PO BOX 532 FOREST, VA 24551 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $69K | $0 | $69K | 78.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203491 DALLAS, TX 75320 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $2K | $0 | $2K | 6.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203491 DALLAS, TX 75320 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $862 | $0 | $862 | 2.44% |
| LARRY W OWEN3 Filed as: LARRY A OWEN | PO BOX 783 SALEM, VA 24153 | AFLAC | $3K | $152 | $3K | 10.31% |
| MJ INSURANCE3 Filed as: JACKSON D RHODES & VARIOUS AGENTS | 525 WEST OAKLAND AVENUE SUITE 7 JOHNSON CITY, TN 37604 | AFLAC | $534 | $0 | $534 | 1.65% |
| KEVIN L MARTIN3 | 1534 LINKS VIEW DRIVE SALEM, VA 24153 | AFLAC | $317 | $0 | $317 | 0.98% |
| JOHN A HAWLEY3 | 1390 SOUTHSIDE DRIVE SALEM, VA 24153 | AFLAC | $190 | $30 | $220 | 0.68% |
| AUBREY W DAMRON3 | 355 STONELEDGE DRIVE ROANOKE, VA 24019 | AFLAC | $153 | $0 | $153 | 0.47% |
| HEATHER D HAWLEY3 | 212 BISHOP ROAD BLACKSBURG, VA 24060 | AFLAC | $90 | $30 | $120 | 0.37% |
| MELVIN R JONES3 | 3025 ELIOCH MANOR DRIVE POWHATAN, VA 23139 | AFLAC | $93 | $0 | $93 | 0.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 613 RIVER PARK ROAD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $0 | $52 | 1.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $0 | $52 | 1.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 601478 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.09% |
| DANIEL OWEN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.09% |
| TRIVETTE WINGO4 | PO BOX 303395 AUSTIN, TX 78703 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $238 | $0 | $238 | 5.51% |
| EMILIE A. DAVIS4 | 17 LINK ROAD LEXINGTON, VA 24450 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $179 | $0 | $179 | 4.15% |
| GROUP AGENCY MANAGEMENT INC.4 Filed as: GROUP AGENCY MANAGEMENT INC | PO BOX 113 VINTON, VA 24179 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $41 | $0 | $41 | 0.95% |
| JUDITH S. BAKER4 | 3434 STONEHENGE SQUARE ROANOKE, VA 24018 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $32 | $0 | $32 | 0.74% |
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 | 564 | 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) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 564 | $3.1M |
| Dental | DELTA DENTAL OF VIRGINIA | 485 | $144K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 389 | $35K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 937 | $181K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 937 | $181K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 937 | $181K |
| Prescription drug | AETNA LIFE INSURANCE CO. | 564 | $3.1M |
| Other(6 contracts, 6 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 937 | $322K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 937 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.