| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | — | UNITEDHEALTHCARE INSURANCE COMPANY | $60K | — | $60K | 14.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | 312 ELM ST FL 24 CINCINNATI, OH 45202 | DELTA DENTAL OF KENTUCKY | $4K | — | $4K | 3.13% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC. | PO BOX 3716 NORFOLK, VA 235143716 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $1K | $10K | 16.49% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | — | UNION SECURITY INSURANCE COMPANY | $5K | $1K | $6K | 26.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | — | EYEMED | $836 | — | $836 | 8.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTHCARE SERVICES INC. EIN 41-1289245 NONE | Other services; Claims processing Service code 12 | — | $117K |
| USI MIDWEST INC. EIN 31-0507943 NONE | Other commissions Service code 55 | — | $0 |
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 | 169 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KENTUCKY | 438 | $127K |
| Vision | EYEMED | 423 | $10K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 191 | $84K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 169 | $401K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 191 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 438 | — |
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.