| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $16K | — | $16K | 9.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | RELIANCE STANDARD INSURANCE COMPANY | $11K | — | $11K | 9.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 100 SUMMIT LAKE DR SUITE 400 VALHALLA, NY 10595 | VISION SERVICE PLAN | $2K | — | $2K | 3.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 100 SUMMIT LAKE DR SUITE 400 VALHALLA, NY 10595 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 8.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM EIN 56-1449504 | Claims processing Service code 12 | PO BOX 11088 CHARLOTTE, NC 28220 | $231K |
| USI INSURANCE SERVICES LLC EIN 13-3771734 | Consulting (general) Service code 16 | 100 SUMMIT LAKE DR SUITE 400 VALHALLA, NY 10595 | $38K |
| B V HEDRICK GRAVEL & SAND COMPANY EIN 56-0257665 PLAN SPONSOR | Accounting (including auditing); Plan Administrator Service code 10 | PO BOX 1040 SALISBURY, NC 28145 | $25K |
| ANDERSON SMITH & WIKE PLLC EIN 27-1473864 | Accounting (including auditing) Service code 10 | 117 STONE HARBOR COURT STATESVILLE, NC 28677 | $6K |
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 | 722 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 723 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 627 | $63K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 746 | $37K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 607 | $168K |
| Long-term disability | RELIANCE STANDARD INSURANCE COMPANY | 604 | $115K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 695 | $475K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 746 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.