| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COMMUNITY INSURANCE COMPANY | $39K | $3K | $42K | 3.13% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $940 | $12K | 16.07% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | DELTA DENTAL OF OHIO | $3K | $0 | $3K | 4.76% |
| DAVID CAMPANA INSURANCE LTD3 | 341 COPPER CREEK AMHERST, OH 44001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.24% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.11% |
| ERIKA M PERRIN3 Filed as: ERIKA M. PERRIN | 11565 GRENADA CIRCLE NE HARTVILLE, OH 44632 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.10% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BENEFITS INC. | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $379 | $0 | $379 | 1.39% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL AND OTHER AGENTS | 3009 WILMINGTON ROAD, SUITE 100 NEW CASTLE, PA 16105 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $180 | $0 | $180 | 0.66% |
| COVEY RUN INSURANCE LLC3 | 6155 PARK SQUARE DRIVE, SUITE 7 LORAIN, OH 44053 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $129 | $0 | $129 | 0.47% |
| TIFFANY M. SEELING3 | 6076 ARLYNE LANE MEDINA, OH 44256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $70 | $0 | $70 | 0.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $976 | $0 | $976 | 6.06% |
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 | 314 | 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) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 273 | $1.3M |
| Dental | DELTA DENTAL OF OHIO | 275 | $67K |
| Vision | VISION SERVICE PLAN | 150 | $16K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $99K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $99K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $72K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 273 | $1.3M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.