| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $29K | $194K | $223K | 5.22% |
| USI INSURANCE SERVICES LLC3 | 1 CONCOURSE PARKWAY NE ATLANTA, GA 30328 | HARTFORD LIFE AND ACCIDENT | $35K | $14K | $49K | 21.05% |
| UNKNOWN3 | UNKNOWN ATLANTA, GA 30313 | WELLFLEET INSURANCE COMPANY | $9K | $0 | $9K | 20.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | $0 | $4K | 10.75% |
| SOURCEONE GROUP LLC3 Filed as: SOURCEONE BENEFITS, LLC | 286 RUE CARIBE MIRAMAR BEACH, FL 32550 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $170 | $0 | $170 | 3.36% |
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 | 445 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 570 | $4.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 570 | $4.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 551 | $33K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 445 | $239K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 445 | $278K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 445 | $234K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 570 | $4.3M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 652 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 652 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.