| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | $91K | $0 | $91K | 3.08% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NJ 07932 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.72% |
| THOMAS J. MCCORD3 | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $509 | $2 | $511 | 2.28% |
| CRYSTAL L MARTIN3 Filed as: CRYSTAL L. MARTIN | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $263 | $20 | $283 | 1.26% |
| USI INSURANCE SERVICES LLC3 | 190 RIVER ROAD, SUITE 101 SUMMIT, NJ 07901 | AFLAC | $274 | $0 | $274 | 1.22% |
| MJ INSURANCE3 Filed as: CHARLES MACKAY AND VARIOUS AGENTS | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $231 | $0 | $231 | 1.03% |
| RYAN H. DALTON3 | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $149 | $61 | $210 | 0.94% |
| BETH A RICHARDSON3 Filed as: BETH A. RICHARDSON | 899 FLEMING AVENUE FAIRMONT, WV 26554 | AFLAC | $133 | $16 | $149 | 0.66% |
| KENNETH L. COTE3 | 11056 SILICA ROAD NORHT JACKSON, OH 44451 | AFLAC | $148 | $0 | $148 | 0.66% |
| MJ INSURANCE3 Filed as: MAURICIO PLATT AND VARIOUS AGENTS | 11839 STEPHENVILLE DRIVE FRISCO, TX 75035 | AFLAC | $120 | $0 | $120 | 0.53% |
| LEIGH ANN KERSTING3 | 48 DONLEY STREET, SUITE 703 MORGANTOWN, WV 26501 | AFLAC | $65 | $0 | $65 | 0.29% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NJ 07932 | AFLAC | $58 | $0 | $58 | 0.26% |
| CHARLES HUGH MACKAY3 | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $55 | $0 | $55 | 0.25% |
| MARY STEWART3 Filed as: MARY L. STEWART | 71 COPPERHEAD LANE FAIRMONT, WV 26554 | AFLAC | $50 | $0 | $50 | 0.22% |
| MJ INSURANCE3 Filed as: RPM LTD AND VARIOUS AGENTS | PO BOX 1016 YULEE, FL 32041 | AFLAC | $46 | $0 | $46 | 0.21% |
| BRIAN CUMPTAN3 | 320 9TH STREET, SUITE 200 HUNTINGTON, WV 25701 | AFLAC | $38 | $2 | $40 | 0.18% |
| JEARL BARNETTE3 Filed as: JEARL D. BARNETTE | 197 STATE LANE DRIVE GRANTSVILLE, MD 21536 | AFLAC | $38 | $0 | $38 | 0.17% |
| KAREN K. BLISS3 | PO BOX 871 PRICE, UT 84501 | AFLAC | $36 | $0 | $36 | 0.16% |
| DAN MOORE3 | 8792 NORTH CLUBHOUSE LANE EAGLE MOUNTAIN, UT 84005 | AFLAC | $34 | $0 | $34 | 0.15% |
| WILLIAM R. ALLMAN3 | 822 MAPLE STREET BRIDGEPORT, WV 26330 | AFLAC | $32 | $0 | $32 | 0.14% |
| DAMON R STREETMAN3 Filed as: DAMON R. STREETMAN | 5894 WEST WILDFLOWER COURT HIGHLAND, UT 84003 | AFLAC | $28 | $0 | $28 | 0.12% |
| RYAN DREBING3 Filed as: RYAN A. DREBING | 2112 NORTH ROAN STREET SUITE 702 JOHNSON CITY, TN 37601 | AFLAC | $25 | $0 | $25 | 0.11% |
| ALEXIE JO CILENSEK3 | 336 A STREET ROCK SPRINGS, WY 82901 | AFLAC | $22 | $0 | $22 | 0.10% |
| BISSELL ENTERPRISES INC3 | 7540 WINDSOR DRIVE, SUITE 306 ALLENTOWN, PA 18195 | AFLAC | $20 | $0 | $20 | 0.09% |
| USI INSURANCE SERVICES LLC3 | 48 DONLEY STREET, SUITE 703 MORGANTOWN, WV 26501 | AFLAC | $19 | $0 | $19 | 0.08% |
| MICHELE BATISTE3 | 1 RUCKERT ROAD MORGANTOWN, WV 26508 | AFLAC | $7 | $7 | $14 | 0.06% |
| MJ INSURANCE3 Filed as: JULIE JOHNSON AND VARIOUS AGENTS | 188 SOUTH CLEVELAND AVENUE MOGADORE, OH 44260 | AFLAC | $12 | $0 | $12 | 0.05% |
| RPM LTD3 | PO BOX 1016 YULEE, FL 32041 | AFLAC | $5 | $0 | $5 | 0.02% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 353 | $3.0M |
| Vision | VISION SERVICE PLAN | 154 | $27K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 204 | $55K |
| Short-term disability | AFLAC | 21 | $22K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 204 | $33K |
| Prescription drug | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 353 | $3.0M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 204 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.