| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 400 HIGHWAY 169 SOUTH, 8TH FLOOR SAINT LOUIS PARK, MN 55426 | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | $53K | $0 | $53K | 1.54% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | $35K | $0 | $35K | 1.01% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE 1ST FLOOR FLORHAM PARK, NJ 07932 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.67% |
| USI INSURANCE SERVICES LLC3 | 190 RIVER ROAD, SUITE 101 SUMMIT, NJ 07901 | AFLAC | $1K | $0 | $1K | 6.21% |
| RYAN H. DALTON3 | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $644 | $100 | $744 | 4.59% |
| CRYSTAL L MARTIN3 Filed as: CRYSTAL L. MARTIN | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $609 | $77 | $686 | 4.23% |
| MJ INSURANCE3 Filed as: THOMAS J. MCCORD AND VARIOUS AGENTS | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $342 | $0 | $342 | 2.11% |
| BETH A RICHARDSON3 Filed as: BETH A. RICHARDSON | 899 FLEMING AVENUE MORGANTOWN, WV 26554 | AFLAC | $269 | $0 | $269 | 1.66% |
| THOMAS J. MCCORD3 | 10 SCOTT AVENUE MORGANTOWN, WV 26508 | AFLAC | $182 | $29 | $211 | 1.30% |
| USI INSURANCE SERVICES LLC3 | 6 CANYON ROAD, SUITE 100 MORGANTOWN, SC 26508 | AFLAC | $49 | $0 | $49 | 0.30% |
| TODD DOW3 | 4918 NORTH PAINTER PEAK DRIVE EAGLE MOUNTAIN, UT 84005 | AFLAC | $280 | $0 | $280 | 4.07% |
| MJ INSURANCE3 Filed as: KAREN K. BLISS AND VARIOUS AGENTS | PO BOX 871 PRICE, UT 84501 | AFLAC | $270 | $3 | $273 | 3.97% |
| KENNETH L. COTE3 | 11056 SILICA ROAD NORTH JACKSON, OH 44451 | AFLAC | $192 | $0 | $192 | 2.79% |
| DAN MOORE3 | 8792 NORTH CLUBHOUSE LANE EAGLE MOUNTAIN, UT 84005 | AFLAC | $149 | $16 | $165 | 2.40% |
| THOMAS J. MCCORD3 | 10 SCOTT AVENUE MORGANTOWN, WV 26508 | AFLAC | $108 | $0 | $108 | 1.57% |
| THOMAS J. MCCORD3 | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $68 | $0 | $68 | 0.99% |
| MARCOS J. MARTINEZ3 | 821 WEST 2700 NORTH LEHI, UT 84501 | AFLAC | $56 | $0 | $56 | 0.81% |
| MJ INSURANCE3 Filed as: RPM LTD AND VARIOUS AGENTS | PO BOX 484 BLOOMINGDALE, GA 31302 | AFLAC | $79 | $0 | $79 | 1.93% |
| THOMAS J. MCCORD3 | 10 SCOTT AVENUE MORGANTOWN, WV 26508 | AFLAC | $64 | $0 | $64 | 1.56% |
| MARY STEWART3 Filed as: MARY L. STEWART | 71 COPPERHEAD LANE FAIRMONT, WV 26501 | AFLAC | $64 | $0 | $64 | 1.56% |
| LEIGH ANN KERSTING3 | 48 DONLEY STREE, SUITE 703 MORGANTOWN, WV 26508 | AFLAC | $53 | $0 | $53 | 1.29% |
| THOMAS J. MCCORD3 | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $46 | $0 | $46 | 1.12% |
| CHARLES HUGH MACKAY3 | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $30 | $0 | $30 | 0.73% |
| BISSELL ENTERPRISES INC3 Filed as: BISSELL ENTERPRISES INC. | 7540 WINDSOR DRIVE, SUITE 306 ALLENTOWN, PA 18195 | AFLAC | $26 | $0 | $26 | 0.63% |
| CRYSTAL L MARTIN3 Filed as: CRYSTAL L. MARTIN | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $163 | $46 | $209 | 5.99% |
| JEARL BARNETTE3 Filed as: JEARL D. BARNETTE AND OTHER AGENTS | 197 STATE LINE DRIVE GRANTSVILLE, MD 21536 | AFLAC | $124 | $0 | $124 | 3.56% |
| THOMAS J. MCCORD3 | 10 SCOTT AVENUE MORGANTOWN, WV 26508 | AFLAC | $43 | $8 | $51 | 1.46% |
| MICHELE BBATISTE3 | 1 RUCKERT ROAD MORGANTOWN, WV 26554 | AFLAC | $35 | $0 | $35 | 1.00% |
| RYAN DREBING3 Filed as: RYAN A. DREBING | 2112 NORTH ROAN STREET SUITE 702 JOHNSON CITY, TN 37601 | AFLAC | $30 | $0 | $30 | 0.86% |
| RYAN H. DALTON3 | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $29 | $0 | $29 | 0.83% |
| USI INSURANCE SERVICES LLC3 | 6 CANYON ROAD, SUITE 100 MORGANTOWN, SC 26508 | AFLAC | $22 | $0 | $22 | 0.63% |
| CHARLES HUGH MACKAY3 | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $37 | $0 | $37 | 2.29% |
| LEIGH ANN KERSTING3 | 48 DONLEY STREE, SUITE 703 MORGANTOWN, WV 26508 | AFLAC | $26 | $0 | $26 | 1.61% |
| THOMAS J. MCCORD3 | 10 SCOTT AVENUE MORGANTOWN, WV 26508 | AFLAC | $23 | $0 | $23 | 1.42% |
| JEARL BARNETTE3 Filed as: JEARL D. BARNETTE | 197 STATE LINE DRIVE GRANTSVILLE, MD 21536 | AFLAC | $21 | $0 | $21 | 1.30% |
| WILLIAM R. ALLMAN3 | 822 MAPLE STREET BRIDGPORT, WV 26330 | AFLAC | $20 | $0 | $20 | 1.24% |
| MJ INSURANCE3 Filed as: RPM LTD AND VARIOUS AGENTS | PO BOX 484 BLOOMINGDALE, GA 31302 | AFLAC | $20 | $0 | $20 | 1.24% |
| THOMAS J. MCCORD3 | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $16 | $0 | $16 | 0.99% |
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 | 318 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 419 | $3.5M |
| Vision | VISION SERVICE PLAN | 178 | $32K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 318 | $42K |
| Short-term disability | AFLAC | 3 | $2K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 318 | $41K |
| Prescription drug | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 419 | $3.5M |
| Other(7 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 318 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
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.