| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD OF FLORIDA | $32K | — | $32K | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD OF FLORIDA | $7K | — | $7K | 4.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1301 GERVAIS STREET, SUITE 500 COLUMBIA, SC 29201 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $2K | $11K | 12.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 11.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 201 ALHAMBRA CIRCLE, SUITE 801 CORAL GABLES, FL 33134 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 6.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 141916 CORAL GABLES, FL 33114 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $124 | $1K | 8.40% |
| SHEALY BENEFITS SERVICES INC3 Filed as: SHEALY BENEFITS SERVICES, INC. | 215 HOGAN WAY LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $511 | $210 | $721 | 4.35% |
| MJ INSURANCE3 Filed as: MARIA D. KADALA AND VARIOUS AGENTS | 1830 NORTH UNIVERSITY DRIVE PLANATATION, FL 33322 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $531 | $111 | $642 | 3.87% |
| GINA MARIE MARTINEZ3 | 2401 NE 65TH STREET FORT LAUDERDALE, FL 33308 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $283 | $196 | $479 | 2.89% |
| GRAEM M CLARK3 | 589 WINDMERE DRIVE LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $161 | $144 | $305 | 1.84% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM, INC. | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | $107 | $222 | 1.34% |
| TIMOTHY J REED3 Filed as: TIMOTHY J. REED | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $187 | $26 | $213 | 1.28% |
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 | 198 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 117 | $972K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 125 | $87K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 125 | $87K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $63K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $63K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $63K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 117 | $972K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.