| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $76K | $0 | $76K | 9.91% |
| BENEFIT EXPRESS SERVICES LLC5 Filed as: BENEFIT EXPRESS SERVICES | 1700 EAST GOLF ROAD, SUITE 1000 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $94K | $94K | 14.78% |
| PREPARE BENEFITS, LLC3 | 10524 MOSS PARK ROAD, SUITE 206-306 ORLANDO, FL 32832 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $0 | $18K | 2.88% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | $34K | $0 | $34K | 10.13% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29K | $15 | $29K | 13.49% |
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 | 1,622 | 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) | 1,622 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,036 | $766K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,036 | $766K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,622 | $639K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,622 | $639K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,622 | $974K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,622 | $851K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,622 | — |
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.