| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 15350 25TH AVENUE NORTH, SUITE 114 PLYMOUTH, MN 55447 | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | $119K | $0 | $119K | 2.93% |
| USI INSURANCE SERVICES LLC3 | 180 PARK AVENUE, 1ST FLOOR FLORHAM PARK, NJ 07932 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $4K | $11K | 14.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC & OTHER AGENTS | 180 PARK AVENUE, SUITE 102 FLORHAM PARK, NJ 07932 | AFLAC | $3K | $153 | $3K | 5.13% |
| BRIDGET DAWN BISHOFF3 | 818 BIG MOUNTAIN DRIVE MORGANTOWN, WV 26508 | AFLAC | $1K | $0 | $1K | 2.32% |
| THOMAS J. MCCORD3 | 36 MULBERRY LANE BRIDGEPORT, WV 26330 | AFLAC | $1K | $0 | $1K | 2.07% |
| BETH A RICHARDSON3 Filed as: BETH A. RICHARDSON | 456 BLACKBERRY RIDGE DRIVE MORGANTOWN, WV 26508 | AFLAC | $649 | $13 | $662 | 1.15% |
| CRYSTAL L MARTIN3 Filed as: CRYSTAL L. MARTIN | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $609 | $0 | $609 | 1.06% |
| DAN MOORE3 | 8792 NORTH CLUBHOUSE LANE EAGLE MOUNTAIN, UT 84005 | AFLAC | $434 | $44 | $478 | 0.83% |
| RYAN H. DALTON3 | 57 LAVISTA DRIVE MORGANTOWN, WV 26508 | AFLAC | $361 | $54 | $415 | 0.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.23% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | AETNA INTERNATIONAL | $300 | $0 | $300 | 30.00% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 448 | $4.1M |
| Vision | VISION SERVICE PLAN | 225 | $41K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 199 | $132K |
| Short-term disability | AFLAC | 81 | $57K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 199 | $75K |
| Prescription drug | HIGHMARK BLUE CROSS BLUE SHIELD WEST VIRGINIA | 448 | $4.1M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 199 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.