| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | USABLE LIFE | $12K | $52 | $12K | 12.83% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $7K | $0 | $7K | 7.77% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 800 CHARLOTTE, NC 28210 | HUMANA INSURANCE COMPANY | $9K | $0 | $9K | 10.82% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | HUMANA INSURANCE COMPANY | $4K | $0 | $4K | 5.41% |
| USI INSURANCE SERVICES LLC3 | 4840 COX ROAD, SUITE 150 GLEN ALLEN, VA 23060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.64% |
| BRIAN OBAL3 | 3190 FAIRVIEW PARK DRIVE, SUITE 40 FALLS CHURCH, VA 22042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $59 | $59 | 0.18% |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 111 | $82K |
| Vision | HUMANA INSURANCE COMPANY | 111 | $82K |
| Life insurance | USABLE LIFE | 158 | $96K |
| Short-term disability | USABLE LIFE | 158 | $96K |
| Other(2 contracts, 2 carriers) | USABLE LIFE | 158 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.