| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUTIE 800 CHARLOTTE, NC 28210 | AETNA LIFE INSURANCE COMPANY | $0 | $49 | $49 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203508 DALLAS, TX 75320 | DELTA DENTAL OF VIRGINIA | $4K | $0 | $4K | 3.00% |
| BENEFICIAL ASSOCIATES, INC.3 | PO BOX 532 FOREST, VA 24551 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $46K | $0 | $46K | 39.52% |
| BENEFICIAL ASSOCIATES, INC.3 Filed as: BENEFICIAL ASSOCIATES | 115 GOLDENROD PLACE LYNCHBURG, VA 24502 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $834 | $0 | $834 | 0.72% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, 8TH FLOOR CHARLOTTE, NC 28210 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $60 | $7K | 8.53% |
| USI INSURANCE SERVICES LLC3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.49% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $60 | $60 | 0.08% |
| LARRY W OWEN3 Filed as: LARRY W. OWEN | PO BOX 783 SALEM, VA 24153 | AFLAC | $3K | $0 | $3K | 9.43% |
| BRIAN CUMPTAN3 Filed as: BRIAN CUMPTAN AND OTHER AGENTS | 320 9TH STREET, SUITE 200 HUNTINGTON, WV 25701 | AFLAC | $533 | $0 | $533 | 1.47% |
| KEVIN L MARTIN3 Filed as: KEVIN L. MARTIN | 1534 LINKS VIEW DRIVE SALEM, VA 24153 | AFLAC | $326 | $0 | $326 | 0.90% |
| AUBREY W DAMRON3 Filed as: AUBREY W. DAMRON | 355 STONELEDGE DRIVE ROANOKE, VA 24019 | AFLAC | $194 | $0 | $194 | 0.54% |
| JOHNE A. HAWLEY3 | 116 PICKENS COURT KINGSPORT, TN 37663 | AFLAC | $166 | $0 | $166 | 0.46% |
| JACKSON D RHODES3 Filed as: JACKSON D. RHODES | 2332 VOLUNTEER PARKWAY BRISTOL, TN 37620 | AFLAC | $148 | $0 | $148 | 0.41% |
| MELVIN R JONES3 Filed as: MELVIN R. JONES | 3025 ELIOCH MANOR DRIVE POWHATAN, VA 23139 | AFLAC | $111 | $0 | $111 | 0.31% |
| TRIVETT WINGO4 | PO BOX 303395 AUSTIN, TX 78703 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $234 | $0 | $234 | 5.30% |
| EMILIE A. DAVIS4 | 17 LINK ROAD LIXINGTON, VA 24450 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $110 | $0 | $110 | 2.49% |
| JUDITH S. BAKER4 | 3434 STONEHENGE SQUARE ROANOKE, VA 24018 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $38 | $0 | $38 | 0.86% |
| USI INSURANCE SERVICES LLC3 | 613 RIVER PARK ROAD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $0 | $54 | 1.25% |
| TRION GROUP, INC.3 Filed as: TRION GROUP | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $0 | $54 | 1.25% |
| USI INSURANCE SERVICES LLC3 | 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% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203508 DALLAS, TX 75320 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $774 | $0 | $774 | — |
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 | 726 | 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) | 726 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 523 | $2.9M |
| Dental | DELTA DENTAL OF VIRGINIA | 500 | $135K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 0 | $0 |
| Life insurance(2 contracts, 2 carriers) | BOSTON MUTUAL LIFE INSURANCE COMPANY | 432 | $194K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $78K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $78K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 523 | $2.9M |
| Other(6 contracts, 6 carriers) | BOSTON MUTUAL LIFE INSURANCE COMPANY | 726 | $250K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 726 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.