| 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 | $92K | $0 | $92K | 2.95% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NJ 07932 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $3K | $9K | 15.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.47% |
| USI INSURANCE SERVICES LLC3 | 48 DONLEY STREET, SUITE 703 MORGANTOWN, WV 26501 | AFLAC | $549 | $0 | $549 | 3.12% |
| MJ INSURANCE3 Filed as: JOHN LACARIA & VARIOUS AGENTS | 102 JENNIFER LANE BRIDGEPORT, WV 26330 | AFLAC | $389 | $0 | $389 | 2.21% |
| THOMAS J. MCCORD3 Filed as: THOMAS MCCORD | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $342 | $0 | $342 | 1.95% |
| CRYSTAL MARTIN3 | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $338 | $0 | $338 | 1.92% |
| BETH A RICHARDSON3 Filed as: BETH RICHARDSON | 899 FLEMING AVENUE FAIRMONT, WV 26554 | AFLAC | $163 | $0 | $163 | 0.93% |
| CHARLES HUGH MACKAY3 Filed as: CHARLES MACKAY | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $66 | $0 | $66 | 0.38% |
| RPM LTD3 | PO BOX 1016 YULEE, FL 32041 | AFLAC | $27 | $0 | $27 | 0.15% |
| DAN MOORE3 | 8792 NORTH CLUBHOUSE LANE EAGLE MOUNTAIN, UT 84005 | AFLAC | $514 | $0 | $514 | 6.80% |
| MJ INSURANCE3 Filed as: KAREN BLISS AND VARIOUS AGENTS | PO BOX 871 PRICE, UT 84501 | AFLAC | $227 | $0 | $227 | 3.00% |
| KENNETH L. COTE3 Filed as: KENNETH COTE | 1056 SILICA ROAD NORHT JACKSON, OH 44451 | AFLAC | $208 | $0 | $208 | 2.75% |
| THOMAS J. MCCORD3 Filed as: THOMAS MCCORD | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $190 | $0 | $190 | 2.51% |
| MARCOS MARTINEZ3 | 821 WEST 2700 NORTH LEHI, UT 84043 | AFLAC | $94 | $0 | $94 | 1.24% |
| CLINT WEIGHT3 | 706 SOUTH 320 EAST SALEM, UT 84653 | AFLAC | $73 | $0 | $73 | 0.97% |
| USI INSURANCE SERVICES LLC3 | 48 DONLEY STREET, SUITE 703 MORGANTOWN, WV 26501 | AFLAC | $20 | $0 | $20 | 0.26% |
| MJ INSURANCE3 Filed as: JOHN LACARIA & VARIOUS AGENTS | 102 JENNIFER LANE BRIDGEPORT, WV 26330 | AFLAC | $107 | $0 | $107 | 2.87% |
| THOMAS J. MCCORD3 Filed as: THOMAS MCCORD | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $104 | $0 | $104 | 2.79% |
| USI INSURANCE SERVICES LLC3 | 48 DONLEY STREET, SUITE 703 MORGANTOWN, WV 26501 | AFLAC | $51 | $0 | $51 | 1.37% |
| CHARLES HUGH MACKAY3 Filed as: CHARLES MACKAY | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $31 | $0 | $31 | 0.83% |
| WILLIAM R. ALLMAN3 Filed as: WILLIAM ALLMAN | 822 MAPLE STREET BRIDGEPORT, WV 26330 | AFLAC | $20 | $0 | $20 | 0.54% |
| RPM LTD3 | PO BOX 1016 YULEE, FL 32041 | AFLAC | $16 | $0 | $16 | 0.43% |
| CRYSTAL MARTIN3 | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $5 | $0 | $5 | 0.13% |
| THOMAS J. MCCORD3 Filed as: THOMAS MCCORD | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $40 | $0 | $40 | 2.33% |
| CHARLES HUGH MACKAY3 Filed as: CHARLES MACKAY | 2383 SOUTH MAIN STREET, SUITE B100 AKRON, OH 44319 | AFLAC | $40 | $0 | $40 | 2.33% |
| MJ INSURANCE3 Filed as: JEARL BARNETTE & VARIOUS AGENTS | 197 STATE LINE DRIVE GRANTSVILLE, MD 21536 | AFLAC | $34 | $0 | $34 | 1.98% |
| USI INSURANCE SERVICES LLC3 | 48 DONLEY STREET, SUITE 703 MORGANTOWN, WV 26501 | AFLAC | $27 | $0 | $27 | 1.57% |
| WILLIAM R. ALLMAN3 Filed as: WILLIAM ALLMAN | 822 MAPLE STREET BRIDGEPORT, WV 26330 | AFLAC | $17 | $0 | $17 | 0.99% |
| RPM LTD3 | PO BOX 1016 YULEE, FL 32041 | AFLAC | $6 | $0 | $6 | 0.35% |
| JULIE JOHNSON3 | 188 SOUTH CLEVELAND AVENUE MOGADORE, OH 44260 | AFLAC | $4 | $0 | $4 | 0.23% |
| UNKNOWN3 | UNKNOWN MORGANTOWN, WV 26508 | AETNA INTERNATIONAL | $150 | $0 | $150 | 15.00% |
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 | 178 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 347 | $3.1M |
| Vision | VISION SERVICE PLAN | 162 | $26K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 178 | $62K |
| Short-term disability | AFLAC | 1 | $2K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 178 | $60K |
| Prescription drug | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 347 | $3.1M |
| Other(6 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 178 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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.